Policy Watch

Charitable Care and Health Reform

For more than four decades charitable care providers have done yeoman work providing care to the poor. Except for a brief period in the 1970’s when the U.S. Department of Health, Education, and Welfare took an interest in the then fledgling movement, charitable clinics’ role and contributions have been largely ignored by policymakers. The Affordable Care Act did little to change that. Nevertheless, the new law portends unprecedented changes in the contexts and conditions that have made free and charitable clinics an increasingly important part of the safety net.

Contrary to the perception of some, the need for charitable clinics is not going away as a result of new law.  Using researcher Dr. Julie Darnell’s paradigm of the charity clinic as first and foremost a “gap filler,” the reform law, and the rules and regulations that follow will present a seismic shift in the major gap – lack of access to affordable insurance – that clinics have been filling for decades. New gaps will emerge, and if charity providers hold to their missions, they will find and focus on those areas of unmet need.

The re-election of President Obama ensures that the health reform law is moving forward. While the Affordable Care Act includes a substantial expansion of health insurance coverage for low-income individuals, those plans are not without challenges. Among the greatest of these will be ensuring that enough providers exist to care for patients.

Also, whether Georgia will move ahead with the Medicaid expansion is unclear. That decision will be determined by the General Assembly and Governor Nathan Deal, who has stated he has no intention at this time of expanding the program.  What is clear however is that the people the 102 free and charitable clinics across the state were built to serve is the same population impacted by the proposed expansion. Our role in delivering health care will not decline, just shift.

As Georgia policymakers rethink the health care safety net to meet the new requirements, we hope they consider the strategic and financial support that our charitable care programs will need to remain and grow as integral access points for care.