The Healing Place

The Affordable Care Act and Indigent Care

The Affordable Care Act and Indigent Care

In October 2013, lower income Kentucky residents could finally get insurance as a result of the Affordable Care Act, or Obamacare. When the bill was signed in 2010, it was going to change the face of healthcare in this country. The hope was that everyone would have good comprehensive healthcare and it would eliminate gaps in care. Things were extra exciting because Kentucky expanded Medicaid eligibility, meaning lots of lower income people would qualify for free Medicaid. It is now 2015 and the reality of the Affordable Care Act is very different than the idealistic world we all pictured before the law passed. But different doesn’t always mean bad. Sure the perfect world of comprehensive care is ideal, but what we have now is still much better than what we had before the Affordable Care Act took effect.

I have been working in the Medical Clinic at The Healing Place for six years and have seen firsthand the struggles the indigent have with accessing our healthcare system on both sides of the Affordable Care Act. Before the law, resources for clients were extremely limited. For basic primary care, people had resources in the form of Family Health Centers and Park DuValle Community Health Centers. These clinics are fantastic and provide dental and health services to low income individuals. There are several of these clinics located throughout Louisville; however without insurance these clinics had a co-pay. A small co-pay may seem insignificant to you and I, but to someone with extremely limited funds, $40 is exceedingly hard to come by. People that are indigent do not have the luxury of a budget allocating regular healthcare costs. Though there were barriers to this care, it was and still is a great option for the indigent.

The real healthcare issue the indigent faced is trying to get connected to specialized care. Getting an appointment with a specialist like a dermatologist, orthopedist, or neurologist could take up to six months. Even getting a MRI could take months. This long wait is with full-time staff contacting providers and advocating for patients. The idea of a vulnerable and indigent person navigating this process on their own was (and still is) laughable. The major impact the Affordable Care Act has had on the indigent population has been in this capacity. Funding was the largest issue before, and now providers can at least bill Medicaid for services. There were limited appointments for people paying for services, and even more limited access for those who would be paying close to nothing.

Don’t get me wrong, the system is still not perfect. Though people have Medicaid, they don’t get into see a specialist in a day, or even several weeks, but the chances of them getting the care they need is much higher. Now when we contact doctors’ offices, the first question we get is “Does the person have insurance?” It is fantastic to be able to say yes and get an appointment on the books for a client in one phone call. The next step forward is an increase in service providers. One of the greatest things about the Affordable Care Act is that our healthcare system is moving in the right direction. Hopefully our country continues to trend in a positive direction.