AmeriCares: No drop in demand at free clinics

One year ago Tuesday we raced against the clock to ensure dozens of uninsured Fairfield County residents met the midnight deadline for the state health insurance exchange. It was a sprint finish for our months-long effort to make AmeriCares Free Clinics patients in Bridgeport, Danbury, Norwalk and Stamford aware of their new health insurance options under the Affordable Care Act. We were successful in helping 300 patients obtain coverage -- about 10 percent of our patient population -- but there are no empty chairs in our waiting rooms: For every patient we lost, two new ones walked through our doors seeking relief from respiratory infections, high blood pressure or in need of a pre-employment physical.

Ever since the Affordable Care Act became law, I have been asked when free clinics like ours can close our doors. Yes, progress has been made and there are more options than ever for the low-income working poor -- including expanded Medicaid eligibility in Connecticut -- but the need for free care hasn't changed since we opened our first clinic 20 years ago.

While many more people have accessed health insurance through the Affordable Care Act, you might be surprised by this dose of reality: occasional clinic closings make headlines, but the opening and expansion of clinics like ours happen quietly almost every day. What most people outside of the free clinic world probably don't know is that many free and charitable clinics are expanding services -- some even adding locations -- to serve more uninsured patients.

We often hear of these program expansions from clinics we serve through AmeriCares U.S. Medical Assistance Program, which provides free medicines and supplies to free clinics and community health centers nationwide. In 2014, one Texas free clinic added a women's health clinic and chronic disease care, which contributed to an additional 1,600 patient visits. At the same time, a Louisiana clinic doubled in size when it moved to a new building last summer.

The National Association of Free & Charitable Clinics reports the nation's 1,200 free and charitable clinics saw a 40-percent increase in patient demand from 2012 to 2014. Little is expected to change; the Congressional Budget Office estimates there will be 31 million Americans uninsured a decade from now. There will still be patients who don't qualify for Medicaid and patients who can't afford insurance deductibles, premiums and co-payments. Many will be exempt from tax penalties.

Here in Fairfield County, the AmeriCares Free Clinics have also added capacity to meet the steady need, putting a mobile clinic on the road in Stamford in 2014. The mobile clinic has exceeded expectations, treating more than 500 patients in the first year. At the busiest locations, our staff and volunteers examine up to two dozen patients in a single five-hour session. The service expansion contributed to an 11-percent increase in patient visits last year.

Part of the influx of new patients in Connecticut can be attributed to the increased awareness about the need for health coverage and the ample promotion of the state health exchange. More often our patients are inquiring about health insurance, and new patients are coming to our free clinics after exhausting their coverage options. And with community health centers across the country taking on hundreds of thousands of new Medicaid patients, it is not surprising that more uninsured patients are seeking out free clinics.

At AmeriCares, we will continue to inform our patients about Access Health CT, Medicaid -- and any other program for which they are eligible -- and we'll be glad to see them move on. But we'll also keep our doors open for the patients who walk in behind them.

Karen Gottlieb, RN, MBA, is the executive director of the AmeriCares Free Clinics, the largest free clinic program in Connecticut, and a board member of the National Association of Free & Charitable Clinics.


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