Finding a ‘medical home’ for all

The Gazette Opinion Staff
Published: March 2 2014 | 12:01 am - Updated: 1 April 2014 | 9:03 am in

By Darlene Schmidt


Since early September, Community Health Free Clinic has been working to educate our uninsured patients on how the Affordable Care Act could help them.

At first, we often see a blank look as if they assumed it had nothing to do with them. Then, disbelief that they can get the coverage offered under the Iowa Health and Wellness Plan.

The majority of our patients are employed, try to be responsible for their own care, but often have household incomes that are identified anywhere from extremely low-income to low-income (0 percent to 200 percent of the federal poverty level).

As an advocate for the uninsured and underserved for nearly 20 years, for the first time I see real hope that thousands of individuals will have a “medical home” that can offer complete and ongoing care. For many, this will be their first experience of having health insurance and the opportunity to seek preventive care.

When Dr. William Galbraith and I co-founded Community Health Free Clinic in 2002, the goal was to have a clinic that was a resource for uninsured and underserved individuals to receive acute or urgent health care at no cost. In recent years, more of our services have focused on chronic disease management, which is not the typical model for most free clinics.

This past year, more than 13,000 individuals across east-central Iowa came to Community Health Free Clinic to access medical, dental or prescription services at a “cash” cost of nearly $1 million.

The clinic receives no reimbursements for services and is funded through contributions, grants and donated goods and services. This past year, $13.80 of health care was provided for every $1 of cash spent.

While the Affordable Care Act will positively impact many individuals, it is not the solution for everyone. We are aware that it does not remove the barriers for all of our at-risk citizens, nor does it eliminate the need for a free clinic in our community. There will continue to be gaps in coverage or situations when someone is unable to afford the out-of-pocket costs of a medical or dental visit.

An unanticipated illness or injury may still require some individuals to choose between seeking care or paying monthly household expenses such as utility bills or purchasing groceries.

Community Health Free Clinic is and will continue to be an active partner in the community effort to promote and offer assistance for enrollment in the insurance Marketplace to our patients and others.

But it is also important that we do not lose sight that there are still many in our community who are in need of the clinic’s services.

Darlene Schmidt is CEO of the Community Health Free Clinic of Cedar Rapids. Comments:

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