By Ann Hyre
On March 23, 2010, President Barack Obama signed into law the Patient Protection and Affordable Care Act (ACA), commonly known as Obamacare. This law is intended to expand health insurance coverage, control health care costs and improve health care delivery systems. Why, then, is there such unrelenting opposition to this initiative?
Although the resistance to ACA may be unsettling, America’s history is rich with examples of individual/states’ rights versus national authority. Although the U.S. Constitution created a strong central government, arguments of individuals’ and states’ rights have persisted. The most notable of these differences resulted in the Civil War but have also included resistance to Franklin Roosevelt’s New Deal programs during the Great Depression; the civil rights movement; the creation of Medicaid as part of Lyndon Johnson’s Great Society and most recently, George Bush’s No Child Left Behind educational initiative and the creation of Medicare Part D for senior citizens.
The ACA has certainly encountered a unique set of roadblocks. Even after passage, the United States House of Representatives voted to repeal or delay the law more than 40 times; 16 states have imposed crippling restrictions on patient navigators, whose function is to educate consumers about their options and help them enroll for coverage and 21 states have refused to expand Medicaid. Coupled with these distractions, the healthcare.gov electronic enrollment system had a less than optimum rollout. However, the fact remains that, although this legislation is a far cry from universal health care and a far cry from perfect, it is a step in the right direction toward providing coverage to those who have been denied access to medical care and treatment due to lack of insurance and income.
In the words of Dr. Martin Luther King, “The ultimate measure of a man is not where he stands in moments of comfort and convenience but where he stands at times of challenge and controversy.” Even though the ACA has certainly generated more than its share of challenge and controversy, 25 percent of West Virginians who were deemed eligible for expanded Medicaid were enrolled in less than seven weeks. The West Virginia Office of the Insurance Commissioner projects that the current 246,000 uninsured West Virginians will be reduced to 76,000 within three years. This is a huge accomplishment for the many groups who have been diligently reaching out to assist individuals in accessing insurance and an even more amazing benefit for thousands of our state’s working poor citizens who have historically suffered significant health disparities due to lack of insurance.
As more West Virginians obtain health coverage through either the ACA’s expanded Medicaid component or the Health Insurance Marketplace, these newly insured citizens will face a different set of challenges: obtaining a medical home. Primary care physicians are in short supply in our state, and many private practices cap the number of Medicaid/Medicare patients they will treat. In order to meet its mission of providing quality health care to the medically underserved, West Virginia Health Right, the state’s oldest and largest free clinic, will continue to provide care and treatment to its existing patient population who become insured through Medicaid.
West Virginia Health Right, which was the first free clinic in the state to obtain Medicaid billing privileges, was founded and continues to operate under the philosophy that all people deserve access to quality medical treatment regardless of financial or insurance status. Because the majority of the clinic’s 21,000 patients suffer from one or more chronic illnesses, it is imperative that they do not face a gap in care. Understanding this need, the clinic is prepared to continue to provide patient centered care and treatment to its existing patients who obtain coverage through Medicaid and to assist patients who do not qualify for expanded Medicaid in understanding and navigating the marketplace in order to obtain coverage. Despite the ACA’s efforts to provide health care coverage for all, there will remain an uninsured and underinsured population that will require the services of the free clinic medical safety net organizations.
As with any systemic change, unexpected hurdles and challenges with the ACA will continue to arise. Through strategic planning and proactive preparation, West Virginia Health Right has positioned itself to face these challenges head-on to ensure that the clinic’s patients continue to receive comprehensive quality health care.
About the Author
Ann Hyre is the Deputy Director of WV Health Right, Inc. She is actively involved in strategic and long range planning to ensure that the medically underserved in our communities have access to quality health care.
