Free clinics still necessary for gaps in ACA

Although healthcare reform aims to expand the number of insured Americans, free clinics are likely to remain just as essential for those most in need, the Wisconsin State Journal reports.

Through methods like Medicaid expansion and subsidies for the online exchanges, reform is expected to add 14 million people to the insurance rolls in the first year alone.

However, nearly 30 million people will still remain uninsured for one reason or another by 2022, according to Congressional Budget Office estimates. For this reason, free clinics will remain an essential community fixture, according to Nicole Lamoureux Busby, executive director of the National Association of Free and Charitable Clinics. "There's a misconception that [healthcare reform] is universal coverage. It's not," Busby told the State Journal. "The Affordable Care Act is just a first step. It was never meant to cover everyone."

For example, Busby cited undocumented immigrants, who are specifically excluded from the law. Others will earn too little for the individual mandate to apply, but too much to qualify for Medicaid coverage. In addition, others won't know they are eligible for Medicaid, will be uninsured during a change of jobs or will voluntarily go without insurance.

More patients are likely to fall through the cracks in states like Wisconsin, where Gov. Scott Walker declined to expand BadgerCare, the state's Medicaid program, and last year raised the program's income eligibility requirement, FierceHealthFinance previously reported.

Some clinics will offer services specifically targeted at the gaps in the law, such as offering services to undocumented immigrants or providing dental care, according to the Boston Globe. Others, such as the Community Connections Free Clinic in Dodgeville, Wis., also will hold seminars this fall to help explain the law, the State Journal reports.

"We want to do everything we can to get any person who wants to and can to sign up for the new coverage," Clinic Manager Molly Zuehlke told the State Journal. "But I think people who work in healthcare don't see this as solving the problem of unaffordable insurance and issues with access."

Confusion among patients might not be what clinics should be most concerned about--some worry that private donors, the primary source of funding for free clinics, may assume there's no need for clinics in the wake of the law, according to the article.

To learn more:
- here's the State Journal article
- read the Boston Globe article
- read the CBO estimates (.pdf)