Medicaid Expansion FAQs

Virginia’s free and charitable clinics have a long history of providing quality care to Virginia’s low-income, uninsured populations and are a very good investment of resources for greater healthcare impact, leveraging $40 million in budgets to provide a total of $191 million in care in just the past year. While Medicaid expansion means more healthcare for more people and is an important step forward for Virginia, it cannot achieve coverage for all. Clinics will continue to be there for those who lack insurance and healthcare options. 

At the same time that Medicaid expansion strengthens Virginia’s healthcare safety net, it also presents clinics with new challenges and opportunities within the shifting healthcare landscape. Clinics will require your continued support during this time of rapid change and mounting challenges so they are able to ensure all people have access to care. Any weakening of support for free clinics would be a major setback for the overall health of our state and impact some of our most vulnerable community members.

Does Medicaid expansion mean everyone across the state can access healthcare?  

Medicaid is health insurance not healthcare. Therefore, while many will find themselves insured for the first time, they might find it just as difficult to receive care. That’s because in Virginia, there are areas with little to no access to health care. These localities are “Health Professional Shortage Areas” and have too few primary care, dental and mental health providers and services. While free and charitable clinics continue to strive to meet the needs in these underserved areas, even within Medicaid expansion, it will be important for partners to work to increase healthcare access across the state.  

Are the working uninsured by choice?  

Most people without insurance, want insurance, but can’t afford it. When working families struggle to make ends meet, co-pays and medical bills become out of reach along with access to preventative care. These same families may also avoid addressing chronic conditions, such as diabetes, that may ultimately result in costly ER visits or hospitalizations. Some families don’t have the means to cover expenses incurred from healthcare. That’s why Virginia’s free clinics are so important. Clinics serve as an important resource for working families who can’t afford healthcare or health insurance. 

How will free and charitable clinics be impacted by Medicaid expansion?   

Thanks to Medicaid expansion, along with the assistance of Virginia’s free and charitable clinics, more Virginians than ever will have access to preventative and life-saving care. Medicaid expansion is a win-win for Virginians and the state’s free and charitable clinics. Approximately 400,000 Virginians could receive Medicaid benefits beginning January 2019. Because Medicaid expansion will not cover everyone, free and charitable clinics will have the opportunity to step in and fill remaining gaps to those who continue to lack access to care. 

Each of our clinics will evolve their operations to continue to best meet the needs of their patients within their community. Here are a few approaches:  
  • Hybrid: Certain clinics will accept Medicaid-enrolled patients, while also treating uninsured patients with certain income levels. Income eligibility will vary based on the cost-of-living in each locality served by the clinic.   
  • Supplemental Services: In locations where Medicaid-enrolled patients have access to providers, free clinics may choose to allocate resources to specialized services that Medicaid may not fully cover, if at all – services may include preventative dental care, optometry, and podiatry. These new clinic specialties can help supplement, not duplicate, services provided by Medicaid.  
  • Expanding Eligibility: In localities where Medicaid-enrolled patients have access to other providers, free clinics will expand their eligibility requirements to serve a broader population of uninsured and underinsured. In this scenario, patients who historically made too much to qualify for a free clinic’s services – but not enough to access traditional insurance – will now be able to access care at a clinic. It has been estimated that as many as 300,000 people will remain uninsured after Medicaid expansion thus further demonstrating the need for clinics. 

How has Medicaid expansion impacted clinics in other states? 

It’s a good trend. From what we understand, when enrollment in Medicaid goes up, and utilization of free and charitable clinic increases. We know that when states expand Medicaid, more people access healthcare. That’s why it’s important to continue investing in healthcare, including the state’s free and charitable clinics. 

Will current patients still need free and charitable clinics?  

Every clinic is approaching their service models differently, based on the needs of their community. Depending on geographic location, some patients may be able to access healthcare using their Medicaid coverage at other facilities. In those situations, free clinics will be able to expand their Federal Poverty Level limits to help more, underserved patients. In other cases, free clinics may accept Medicaid covered patients and continue to see the same patients they’ve seen for years. Regardless of the approach a clinic chooses, our facilities will continue to be busy serving patients who lack access to health care. We will need the help of our volunteer providers to continue this important work.  

Will clinics still need support from medical volunteers? 

We know that medical volunteers are committed to helping the uninsured and underinsured. Medicaid expansion means more people with access to health care coverage and free clinics are an integral part of this effort. To make Medicaid expansion successful, we need the help of medical volunteers more than ever because volunteers help to make  our health care services affordable for patients, the community and an excellent return on investment for donors.  

Why is it important to continue funding clinics within Medicaid expansion?  

Free and charitable clinics remain an important part of Virginia’s healthcare safety net, even after Medicaid’s expansion on January 1. For years, Virginia’s free clinics only had the capacity to serve people with very low incomes. With Medicaid expansion, this population will have new options for healthcare, which gives free clinics the opportunity to evolve to continue to serve these newly covered patients and/or expand to serve new, underserved patients such as Virginia’s working families. But even with enhanced Medicaid coverage, Medicaid does not cover all necessary health services; this is another place where clinics can have a great impact – continuing to fill a gap in services where none exist.  

For Medicaid expansion to have the greatest impact, it’s imperative to continue funding Virginia’s free and charitable clinic network. 

A Lifesaving Investment

Working towards a Virginia where all people have access to comprehensive, quality healthcare by supporting and advocating for our member clinics so that hardworking individuals and families are protected from healthcare crises.