Dying for Care is a nine-part series on a New York opera singer's experience living with throat cancer without health insurance. The Related Stories section features accounts of other uninsured Americans as told to writer Christine Show and the future of health care under the Affordable Care Act.
As millions of Americans without health insurance are supposed to get coverage later this year through a new federal law, organizers of free medical clinics tied to churches say their work with the uninsured won't slow down.
President Barack Obama's administration have said the Affordable Care Act's goal is to greatly reduce the number of uninsured by having Americans sign up for health plans beginning Oct. 1. But organizers of clinics nationwide that are typically connected to churches and often considered the only medical care option for the uninsured say the law won't significantly cut their patient population. Instead, clinic directors expect a new set of challenges, including adjusting how they dispense care and gaining new patients confused of their options.
“We've been working very hard trying to determine the community's needs in light of Affordable Care Act,” said Barb Grinwis, executive director for the Oasis Hope Center, a faith-based clinic in Grand Rapids, Mich. “I don't think there will be any diminishing in the amount of people we serve.”
Grinwis runs the volunteer clinic with husband, Dan, the center's vice president. They said they expect a portion of their 40 to 50 weekly patients to become eligible for Medicaid, a government-run medical insurance, through the health reform. The clinic currently serves people who don't have any insurance.
But the new law may motivate other area free clinics to shift from helping the uninsured to serving only the new Medicaid population, the Grinwis couple said. This might prompt those remaining uninsured to turn to the Oasis center for help.
“We may lose patients to Medicaid, but we will probably pick up new patients from other clinics,” said Dan Grinwis. “It will be a trade-off, I think.”
The reform, which will be mostly implemented by January 2014, will also require people to get insurance or pay a fine. The penalty for the first year is $95 for an individual. Fines rise in subsequent years as taxpayers indicate on their tax reforms whether they have insurance. Many Americans may choose to pay a fine to avoid monthly premiums, Barb Grinwis said.
“How many of those we currently serve are even going to purchase insurance?” she said. “There's always going to be people who opt not to have insurance.“
And clinics are also gearing up to serve a portion of the population not eligible for any coverage.
People who entered the country without legal permission won't qualify for insurance under the reform. Some state governments have decided against expanding its Medicaid program leaving millions without access to affordable coverage.
“There's this misconception that everyone is going to get a medical insurance card in the mail in January 2014,” said Nicole Lamoureux, executive director of the Washington, D.C.-based National Association of Free and Charitable Clinics.
And the law only covers medical services leaving other types of care still out of reach.
“There's mental health, dental care, access to medications - all of those are necessary to be healthy and they are not addressed in the Affordable Care Act in totality,” Lamoureux said.
And if a sizable portion of Americans does gain health coverage through the years, faith-based clinics will likely shift their service to fulfill other community needs, said Vicki Jordan, coordinator of the Sharon Community Clinic in rural Arp, Texas. The all-volunteer group also preaches their Christian faith to patients.
“If everybody got health care, there's always some other social ill,” Jordan said. “We'll just step into that.”
But as she sees the number of patients grow at her clinic, Jordan said the free services offered to her community will likely continue long after the law is implemented.
“I honestly do not have hope - I wish I did - that this insurance change is going to pull us out of the dumpsters,” Jordan said. “I think it's just a Band-Aid in the hole in the dam.”
As for Barb Grinwis, she said she already is trying to remind people familiar with her clinic in Michigan not to stop offering support and help when the law takes effect.
“I believe our biggest hurdle come January 2014 with all this hoopla will be to convince people that there still is a need out there,” she said. “People will think that now everybody will have insurance. And that won't be the case.”
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