Kaine talks health care during visit to Free Clinic of Culpeper

Brenda Roy doesn’t have health insurance.

A lifelong Culpeper resident, Roy, 59, only had one place to turn – The Free Clinic of Culpeper.

Since she started to coming to the clinic two years ago, Roy has seen her health return and the clinic helped her get her blood pressure issues under control.

She told her story last Friday to Sen. Tim Kaine, D-Va., during his visit to the Free Clinic.

Kaine has been touring Free Clinics across the Commonwealth following his appointment to the Health, Education, Labor and Pensions committee in January.

He sat down with Roy and other patients at the Free Clinic to find out what services they are provided and how the potential repeal of the Affordable Care Act would impact them.

“I was having some health problems and I wasn’t getting the satisfaction I needed,” Roy told Kaine. “I came here and they have met every possible need I could have.”

She said the caring staff has turned her life around, recommending programs that have improved the quality of her life and truly caring about her well-being.

“Without it, we would truly go down,” Roy said. “The help I’ve received from them, my job didn’t offer me any kind of health care.”

She has since lost her job and is unemployed, and her husband retired. Without a Free Clinic in the community she would have wasted away she said.

“Since I’ve come here it’s been moving forward,” Roy said. “I think what it is, is that they are compassionate. They talk to you. They put you at ease.Then you are able to open up and tell them what you’re needs are. Whatever you bring to them, they have a solution to it.”

Robert Shaw, 55, recently moved to back to the area after working in Northern Virginia in social services for the Diocese of Arlington. He has since fallen on tough times and came to the clinic for the first time the day prior to Kaine’s visit. He talked about the uncertain state of health care with the senator.

“It’s so tenuous right now, people are uncertain about what’s going on,” Shaw said. “It’s difficult to access where the future is going to lie. It’s very scary.”

Shaw had insurance previously but the out of pocket expenses and the deductible was high. Now he has turned to the Free Clinic for help and said others shouldn’t be ashamed to do the same.

“If you don’t have your health, what do you have? You don’t have anything,” Shaw said. “You do whatever it takes to get what you need, and unfortunately I’m in a situation where I have to do whatever it takes.”

According to Chris Miller, executive director of the Free Clinic of Culpeper, the clinic saw 441 people last year. They’ve averaged 12 new people a month since January and she said if the ACA is repealed, they could have an even bigger influx.

“When the ACA was first enacted we saw about 10 percent of our patients leave to go on that,” Miller said. “In the last three months or so we started seeing former patients coming back to us because they can’t afford their copays and deductibles.”

Miller said that Linda Wilkinson, CEO of Virginia Association of Free and Charitable Clinics, recommended Culpeper because they are a smaller clinic, but they’ve been doing a lot in the last year to increase access such as hiring a Spanish speaking administrative coordinator, adding a bilingual volunteer pharmacist and increasing transportation access to the clinic. They are also expanding hours on Thursdays from 1 to 7 p.m. to try to provide access to those who work during the day.

The Free Clinic receives state funding through the VAFCC based on the number of patients they see. They have the capacity to see 75 patients a week fully staffed, and last week saw 55.

She said that lobbyists have already talked about federal funding in case the ACA is repealed.

“One of the nice things about being a member of the Virginia Association of Free Clinics and Charitable Clinics, is that also makes us members of the national organization of free clinics,” Miller said. “They have already started talks if this happens that free clinics should be the beneficiary of any funding because we will be seeing so many people.”

They are fully staffed at the moment with a full time physician’s assistant, full time nurse patient care coordinator, part time nurse, full time front desk and a full time referrals coordinator.

They rely on 41 volunteers including physicians, nurses, pharmacists and administrators.

Miller said that they also can help some of those with a behavioral health need, of which 70 percent of their patients qualify for. Otherwise they are referred to another agency.

“We’ve been able to meet the need of the folks who need some general counseling,” Miller said. “The folks who are in crisis we refer to Rappahannock Rapidan Community Services. But that process can take a little time.”

Kaine’s thoughts on health care

Kaine talked with patients, administrators and staff during his visit. During a wide ranging sit down interview he detailed the difficulty he imagined his committee facing in the coming two weeks. He said he expected the Republicans to try to push through a plan through the Senate without any Democratic votes, similar to how to first ACA was enacted.

One of the questions he received, and hears often, was what type of insurance does he and other staffers have.

“We have a pretty traditional employer provided plan,” Kaine said. “The federal government pays a part of it and the employee pays a portion. If you worked for Dominion, Geico, it’s just a traditional plan. I pay monthly for it for my family.”

He said that having a safety net like a Free Clinic was important for those who cannot afford insurance but said that the more people on insurance will lower the cost.

“It’s one of the issues we grapple with,” Kaine said. “We are really trying to get young healthy people sign up for insurance. Insurance works better for everybody if everybody is part of it.”

He talked about Virginia’s decision to not opt into expanded Medicaid, asking why they wouldn’t accept federal dollars if they have access to it.

“I just think it is so foolish what Virginia has done,” Kaine said. “Why wouldn’t you do it when the federal government is paying for it. If they stop paying for it you say ‘I guess we can’t do it anymore.’”

Kaine said about 15 states are paying the taxes and not receiving the services, and around 400,000 people in Virginia could be covered if Medicaid was expanded.

“I don’t want to phase out Medicaid expansion because I think Virginia will ultimately realize how foolish it is to pay the taxes and not get the benefit,” Kaine said. “Medicaid expansion should stay permanent.”

When asked about working across party lines, Kaine said it happens more often than the public hears about but said “cooperation isn’t that interesting.” He did agree that not enough is happening on big issues, such as health care.

He said he was concerned that the latest health care bill has not been seen or debated and argued that Republicans had plenty of say on the original ACA.

“At the end of the day, no Republican would vote for it on the floor,” Kaine said. “When the ACA was up they had 50 hearings. There were 145 Republican amendments written into the bill. It was written and shaped by Republicans.”

By having no hearings or debates on the bill, Kaine is convinced it will be a topic that never dies.

“It’s guaranteed to fail and we’ll back here a year from now and people who have lost insurance will be really mad,” Kaine said. “It’s not going to get fixed unless we can look at each other across the table and do it together.”

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