Editor, Gazette Journal:

This letter is in response to Mr. Hicks’s recent letter to the editor regarding why Gloucester-Mathews Free Clinic will still be needed after the Affordable Care Act is implemented in 2014. The Affordable Care Act (ACA) will result in health insurance for many uninsured Virginians. However, a recent study commissioned by the McDonnell administration estimated that 289,000 Virginians with incomes ≤ 200% Federal Poverty Level would remain uninsured after ACA’s implementation.

The current capacity of Virginia’s health safety net organizations (198,000 uninsured Virginians last year) is insufficient to treat all those who will need its services after ACA implementation.

If Virginia approves to implement the Medicaid expansion program, about 50 percent of our 2,000 patients will qualify for Medicaid in 2014. But where are they to go? In August 2012, the Kaiser Family Foundation published "Study: Nearly a Third of Doctors Won’t See Medicaid Patients." According to the study, only 76 percent of Virginia’s physicians currently take Medicaid patients. Virginia’s free clinics are concerned that many current patients of the free clinics will receive a Medicaid card but will be unable to find a physician who will take Medicaid patients.

The shortage of Medicaid providers in many areas is leading many free clinics to consider the adoption of a hybrid model of operation—where both the uninsured and those newly covered by Medicaid are offered services.

The Gloucester-Mathews Free Clinic, since its inception in 1998, has evolved its service delivery according to the needs of the community. Initially, the free clinic saw patients only with acute problems, then, recognizing the high percentage of patients with chronic disease, started providing chronic care clinics. In the last four years, the clinic has seen the growing need for dental care, as evident by hundreds of patients waiting overnight in their cars to be seen at a one-time per year Mission of Mercy dental event held at Gloucester High School. Thus the Gloucester-Mathews Free Clinic has responded to this need by including dental care as a major focus area of our mission.

Mr. Hicks, thank you for your kind words regarding the services that the free clinic has provided to the uninsured for many years. We all can debate whether the Affordability Care Act is a good piece of legislature, i.e., dental services are not included. However, the fact remains it is the law and has been affirmed by the Supreme Court. The Gloucester-Mathews Free Clinic has chosen to rise to the challenge of the shortage of Medicaid providers. The clinic is expanding its capacity to serve a combination of uninsured and Medicaid patients so all indigent patients will have access to health care. We promised the community at our inception that we would serve those without access to care. In 2012, and forward, we intend to keep that promise.

Adam Taylor, President

Gloucester-Mathews Free Clinic