Health care access and affordability is arguably more crucial than ever amid the coronavirus pandemic and a presidential election offering two different views on health care.
Record unemployment numbers led to millions of Americans losing their employer-sponsored health care coverage in 2020. And while some are enrolled in programs like Medicaid, Medicare, and COBRA, others are turning to free and charitable health care clinics.
A report from the National Association of Free and Charitable Clinics (NAFC), which serves approximately 2 million patients across 1,400 clinics nationwide, found that 74% of its clinics have experienced an increase in new, unemployed patients seeking medical care.
“For many people, when they lose their jobs, they suddenly lose their insurance and they don’t have any place to go, perhaps for medication refills,” NAFC Board Chair and Grace Medical Home CEO Stephanie Garris told Yahoo Finance. “Immediately when there’s severe economic hardship, they’re focused on putting food on their table, keeping their homes, keeping their cars, and looking for another job.”
As a result, Garris said, health care is often an “afterthought.”
“So, they need a place to go quickly to either deal with an acute issue,” Garris said. “If they’re concerned that they’ve contracted COVID, where did they go from there? Or if they need their medication refills or other medical services. So they’re turning to free and charitable clinics in astonishing numbers.”
‘Only getting worse’
Primary care practices and hospitals have seen plunges in patient visits and use of their services since the start of the pandemic in March.
Fear of contracting coronavirus is certainly a factor, and lack of health insurance is also playing a role.
“What we know is that there’s roughly 14 million people who have lost their jobs,” Garris said. “When you have such a large influx of the number of uninsured, if there are acute medical needs that need to be addressed, they simply suddenly have no place to go. And affordability for many of them is simply out of reach, whether it’s maintaining a relationship with their private practice doctor or certainly attending an emergency room. That’s something they just don’t want to do because of affordability. So, they increasingly turn to free and charitable clinics to meet their medical needs.”
NAFC clinics offer services like X-rays, lab work, specialty care, primary care, and acute preventive care, along with COVID testing, medication distribution, and food distribution. The organization is unable to receive federal funding and relies solely on volunteers and fundraising to maintain operations.
Garris doesn’t see NAFC’s work getting easier any time soon.
“We see that only getting worse until we can really get back employed, get our unemployment rate back down to levels where people have access to employer-sponsored health care and have more stability in meeting their medical needs,” she said.
Garris is based out of the Orlando area, which heavily relies on the tourism industry.
“They’re only going to get worse. What we know, for instance in [Orlando-based] Disney World, is thousands upon thousands of job losses,” she said. “For many in the central Florida community, they were furloughed. Some of these tourism industry workers, hospitality workers, which is one of the key, hardest hit segments of the pandemic. But now those furloughs are ending and insurance that was deferred under the furlough is ending.”
If the ACA is repealed
Along with the millions of people who have lost their employer-sponsored health insurance is the added uncertainty of the status of the Affordable Care Act (ACA), otherwise known as Obamacare.
The fate of the health care legislation lies in the hands of the Supreme Court, which will begin hearing arguments for the case on Nov. 10. The likely confirmation of Supreme Court nominee, Amy Coney Barrett, who has been previously critical of the ACA, has added to the concerns.
If the ACA is repealed, according to Garris, it would put even more strain on free and charitable clinics’ ability to serve more patients.
“There’s always such demand even before the pandemic with record low uninsurance rates, and the more access to plans such as the ACA, there’s still a huge need,” she said. “The ACA was never about universal coverage. In my clinic, for instance, a third of my patients are foreign born. They couldn’t access the Affordable Care Act.”
A key component of the ACA was its expansion of Medicaid, which provided millions more Americans with health insurance.
“In my state that didn’t expand Medicaid, affordability was an issue,” Garris said. “60% of my patients live below 100% of the federal poverty level. So if the ACA is overturned, it’s going to put even more strain on free and charitable clinics to serve those most in need who have no other source of ongoing medical care.”
Adriana Belmonte is a reporter and editor covering politics and health care policy for Yahoo Finance. You can follow her on Twitter @adrianambells.