Affordable Care Act and Free Clinics

January 10, 2013 — Leave a comment

The text below is modified from a document another Director and I wrote regarding our free clinic based in New York City. I feel it is necessary to disseminate this information in order to dispel beliefs that nearly all those living in the United States will have access to healthcare in the next 5-7 years.

Our clinic has a mission “to provide high-quality, accessible healthcare to uninsured adults through consultation, treatment, preventative care, and referral services, at little or no cost.”  The signing of the Affordable Care Act (ACA) in 2010, colloquially known as “Obamacare,” redefines the population of uninsured adults in the United States. However, a significant portion of this group will remain uninsured, and free clinics will continue to provide a safety net for this population.

We currently admit uninsured adults who earn less than 400% of the Federal Poverty Level.  Thus, our clinic provides services to those who do not have access to healthcare and cannot afford the options available.  The ACA is often portrayed as near “universal coverage,” especially in the popular media.  Unfortunately, this portrayal does not reflect reality. The Congressional Budget Office estimates that from 2014 through 2019, the number of uninsured adults in the United States will be reduced by about 32 million through mandates and subsidies.  However, this leaves over 23 million uninsured by 2019. While a significant reduction, this leaves a wide gap that must be filled by safety net programs.  About 4-6 million will pay some penalty in 2016, with over 80% earning less than 500% of the Federal Poverty Level. (Note that increases in the estimates of the number of insured from 23 to 26 million by the CBO reflects changes in Medicaid legislation.) The uninsured population will include, but will not be limited to, undocumented immigrants, those who opt to pay penalties, and those who cannot afford premiums (often those earning less than 500% of the Federal Poverty Level). Thus, many may still be unable to afford options available, and free clinics will continue to welcome them.

The gap in healthcare access will be reduced over the coming years.  Even with this reduction, the number of uninsured adults will remain many. Community healthcare programs across the country shall continue to provide coverage for those who need it most.

References:

  1. Congressional Budget Office, “Selected CBO Publications Related to Healthcare Legislation, 2009-2010.” http://cbo.gov/sites/default/files/cbofiles/ftpdocs/120xx/doc12033/12-23-selectedhealthcarepublications.pdf
  2. Congressional Budget Office, “Another Comment on CBO’s Estimates for the Insurance Coverage Provisions of the Affordable Care Act.” http://www.cbo.gov/publication/43104
  3. Congressional Budget Office, “Estimates for the Insurance Coverage Provisions of the Affordable Care Act Updated for the Recent Supreme Court Decision.“ http://www.cbo.gov/publication/43472
  4. Chaikand et al, “PPACA: A Brief Overview of the Law, Implementation, and Legal Challenges.” http://www.nationalaglawcenter.org/assets/crs/R41664.pdf
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