Affordable Care Act raises questions about future of free clinicsAs the Affordable Care Act now requires all people to get insurance, there are still questions about what this means for the future of free clinics.
By: Maureen McCollum, Wisconsin Public Radio, Superior Telegram
Wisconsin’s 56 free clinics are staffed with volunteers that treat uninsured patients for anything from the flu to cancer. As the Affordable Care Act now requires all people to get insurance, there are still questions about what this means for the future of free clinics. This is part two of Wisconsin Public Radio's week-long series looking at the Affordable Care Act.
At InHealth Community Wellness Clinic in Boscobel, dental coordinator Maureen Koehl helps a volunteer dentist clean a patient’s teeth. The clinic is open a couple times a week for free medical and dental care.
Sixty year-old Koehl not only works at InHealth, but has been a patient for years. She has debilitating arthritis in her knees, but has not been able to afford a double knee replacement or insurance to cover it.
“You know it’s bad when your dentist is telling you, you really need to get your knees fixed because you’re tearing your teeth up in the back because you’re biting so bad,” says Koehl.
Koehl has high hopes for the federal marketplace now available through the Affordable Care Act. She even stayed up until midnight the day it opened to be one of the first to purchase coverage.
Koehl’s still not sure she can afford insurance, even with federal subsidies.
“If you shell out, let’s say $500 a month for 12 months, that’s a pretty big hit out of my husband’s retirement,” says Koehl. “A tax credit isn’t going to give us a lot of a break. Now if it was something instantly, that would be different.”
Koehl says she’d love to get care outside the free clinic.
Jerry Bass is another regular InHealth patient who comes monthly to get his prescriptions filled. Bass works at a nearby winery, but says he could only afford to pay so much for health insurance monthly. He’s currently paying off medical bills from years ago and he lives paycheck to paycheck.
“It’d be like going out and buying a new car,” says Bass. “I don’t know what they’d charge a month – $200, $100, $300? If that was the case, I still don’t know what we’d do.”
Bass, like many patients who go to free clinics, does not know much about the Affordable Care Act. Most clinics are doing what they can to educate people. Some places are handing out informational pamphlets while others are training volunteers to sign people up for the marketplace.
It’s still unclear if Wisconsin’s free clinics will end up with more or fewer patients. There will always be a need to treat undocumented immigrants, people who don’t want coverage, and people who fall through the cracks.
After the state rejected federal Medicaid expansion funds, 92,000 people will lose BadgerCare Plus coverage this year. The intent is for these people to purchase their own insurance.
St. Clare Health Mission is a free clinic in La Crosse. Executive director Sandy Brekke believes that some people who will lose their Medicaid coverage will seek care at the clinic, including people who fall under certain poverty levels – for example, a single person making about $11,500 to $16,000 annually.
“So that’s a group we’re waiting to see, when they get into the marketplace and they apply – even with the cost-sharing and the tax credits – are they going to be able to afford it?”
A Kaiser Family Foundation study found that uninsured adults in Wisconsin will not fall into this predicted coverage gap next year. Also, some low-income people will be exempted from the penalties that come with not purchasing health insurance.
Regardless how many people will still need care at free clinics, Brekke and others say they ultimately want to close their doors.
“People die because they waited until something was so bad there was nothing more that could be done for them,” says Brekke. “If I’m out of a job because everybody that needs health care has health care, that’ll be a great day for me.”
Brekke says she doesn’t see that happening any time soon.