Mission Lexington, which provides health care to the uninsured and the working poor, is tweaking its mission because of the nation's new health care law by redefining the population it serves and letting the public know that free care is still needed.
Under the Affordable Care Act, every American is required to have insurance so, theoretically, free clinics won't have any patients.
But the reality is much different, Mission Lexington executive director Chris Skidmore said.
"There are 975 on a waiting list" to get either medical or dental help, Skidmore said. "The Affordable Care Act won't touch that." Many of those people, he said, will continue to need to find medical and dental care.
One of the challenges facing Mission Lexington and other free clinics, he said, is "letting the public know there is still a need for free clinics."
Since Oct. 1, when enrollment under the new law began, about 195,000 people in Kentucky have signed up for state-sponsored Medicaid, which provides coverage to the poor, or private health insurance. That is out of about 640,000 uninsured in the state. So it's true that more Kentuckians will have health insurance.
Skidmore said, though, that some people with private insurance will face high deductibles that they can't pay. Others, he said, won't sign up even if they do face a fine because they don't qualify for Medicaid and can't find room in their budget to pay for health care.
"Medical care is so far down the list of priorities when you are struggling with other things," he said. "We exist because we want to catch people who fall through the gaps."
There is another group: Newly documented citizens aren't eligible for Medicaid for five years.
Last year, Mission Lexington provided 3,482 patient visits. Next year, he said, the nonprofit is looking at doubling the number of patients in the dental clinic and at operating the medical clinic full time. Both clinics are staffed by volunteer health professionals. The dental clinic began in June 2006, and the medical clinic was launched in December 2008.
So if more of the potential clients are getting insurance, why not start to accept insurance?
Skidmore said Mission Lexington's mandate as a nonprofit doesn't allow for it to handle insurance. Plus, he said, the logistics and manpower it would take to process insurance are not in place. Also, Mission Lexington currently has two full-time employees, and the resources that would go to billing are better directed at patient care, he said.
Mission Lexington is exploring ways to adapt to the new health care landscape, including looking at expanding services into other counties. But that can't be done without a steady and growing stream of volunteers and donors, he said.
While benefitting from a generous group of donors, Mission Lexington has seen a dip in donations, "Our ultimate goal is to put ourselves out of business," he said.