The Affordable Care Act was supposed to make healthcare affordable. It was supposed to provide access to healthcare for the uninsured.
In the pre-ObamaCare America, free and charitable clinics filled the gap for the uninsured. But with millions of newly insured Americans under the ACA, the situation should be different. The White House has repeatedly trumpeted that “the law is working” and millions of more Americans have health insurance. You would expect this has put free and charitable clinics largely out of business.
You would be wrong. Exactly the opposite is actually happening. Orlando Sentinel reporter Naseem S. Miller interviewed Mark Cruise, executive director of The Florida Association of Free and Charitable Clinics. His responses are startling.
Miller: How does Florida compare with other states in the number of free clinics?
Cruise: The state has more than 100 free and charitable clinics. This is a number that’s growing, even as we speak. We know of at least half a dozen new clinics that are in formation in different areas of the state.
Miller: Why do you think that is?
Cruise: Success begets success for one thing. So when one community has a stellar clinic that does a good job of meeting the needs of the uninsured, the word gets out and soon another community wants to do something similar, and before long you have a number of communities that are engaged in this kind of effort.
And obviously the demand for affordable health care for uninsured is not going away or diminishing, but it’s increasing. So certainly, the need is there. Until everyone has care, we’re going to roll up our sleeves and work very hard and take care of those who have been left behind by our health care system.
Miller: What role do free clinics play in communities?
Cruise: When you get right down to it, what we are in communities, we are gap fillers. Just so happens that the biggest gap in healthcare has been access to affordable health insurance and healthcare. Interestingly, in the age of the Affordable Care Act, when hypothetically more people have affordable health insurance, the question for our sector has been what would be the new gaps that we end up filling.
Here in Florida, especially because we have not seen fit to expand Medicaid, we haven’t had to really address that question yet. There are still plenty of gaps in access to affordable healthcare. We’re looking at excess of 2 to 3 million people who don’t have health insurance and two-thirds of them are low income. Even if Florida expanded Medicaid, studies indicate that there will be 1.5 million Floridians uninsured.
I do communicate with my colleagues in other states that have expanded Medicaid and even in those states, the free and charitable clinics are thriving and flourishing, because there remains gaps, maybe due to lack of Medicaid providers to see this whole population of newly enrolled people. Or, maybe it’s what we see here: people who sign up for coverage in the marketplace, it may be the first time they’ve ever had health insurance. The premium was affordable, but they get sick, or they need to go to the hospital and they learn that they have deductible and co-pays that suddenly it’s a little bit beyond their reach. We’re seeing some people dropping off the rolls of coverage and coming back to our clinics, and that’s distressing to us, but it’s reality.
(emphasis added is mine)
The Take-home Messages
In this short but revealing interview, we have learned several key points:
- Despite the ACA, free clinics are growing
- The demand for affordable healthcare for the uninsured is increasing
- There remains a gap in providing affordable healthcare
- Even in states that expanded Medicaid, free clinics are growing
- Even those with ObamaCare insurance can’t afford to see a doctor
- People are dropping their insurance since they can’t afford the deductibles and co-pays
The goal is not providing people with insurance. The goal is providing people with healthcare. If we lose sight of this important distinction, we have failed the American people. ObamaCare is a failed healthcare system. We must do better.