Nonprofit Free Clinic: We Were Serving Fewer People and That Was a Good Thing

January 31, 2017; Leader Telegram (Eau Clair, WI)

For some nonprofits, the “pie in the sky” goal is to help fix the system to the point that the nonprofit no longer needs to exist. When looking at healthcare providers, the same goal applies to nonprofit free clinics that make up the safety net in many communities, as they see patients regardless of insurance status or ability to pay. These organizations were one step closer to their goal with the Affordable Care Act, since a percentage of patients qualified for expanded Medicaid availability in many states, marketplace plans, or subsidies and could establish a permanent medical home.

While the inevitable impending changes to the Affordable Care Act will likely have broad ranging implications for the healthcare market overall, it will have a particularly negative impact on nonprofit free clinics. Maribeth Woodford, executive director of the Chippewa Valley Free Clinic (CVFC) says, “Before the Affordable Care Act, we had more people coming through our doors than we could manage. With the changes, we could give comprehensive care to our clients.” CVFC staff helped patients qualifying for the ACA sign up for plans and through their efforts, the number of patients they served without insurance dropped five percent between 2013 and 2016. Woodford expressed concern that if the ACA is repealed, their clinic will be overrun with patients again.

CVFC is not alone in its concern; in fact, the majority of the country is worried about loss of coverage if the ACA is repealed. A poll by the Associated Press-NORC Center for Public Affairs found that 56 percent of adults are “extremely” or “very” concerned that people will lose health insurance. Representatives from both sides of the aisle, whether they approve with all aspects of the law or not, seem to agree that people should not lose coverage. While Trump has indicated that he wants to replace the ACA with a plan that not only provides insurance coverage but also costs less, U.S. News comments that “his pick for health secretary recently cast doubt on the notion that a Trump administration replacement is ready to go.”

However, Dr. Eric Jamelske, an economics professor at University of Wisconsin–Eau Claire, makes a poignant argument, “The reality is in economics we like to say there’s no such thing as a free lunch. I can’t imagine a world where all of a sudden everyone’s covered. If it were that easy, wouldn’t we have done it a long time ago?”

With changes occurring rapidly under the new administration, it should be noted that a recent Quinnipiac University Poll found that 84 percent of voters indicated that the ACA should not be repealed until a viable replacement has been determined. Furthermore, in both the Associated Press poll and the Quinnipiac University poll, it was found that the majority of U.S. adults do not want the entire act repealed, but rather just fixed, particularly regarding the individual mandate.

Woodford sums up the way, it appears, much of the country feels: “We want everyone to have coverage. But we, like everyone else, have to do the wait-and-see.”—Sheela Nimishakavi