Supreme Court Ruling

The Impact of Supreme Court Decision on Volunteers in Medicine Clinics


The Supreme Court’s affirmation of the constitutionality of the Affordable Care Act (ACA) allows the country to proceed with plans to implement the many provisions of this historic health care legislation. Since March 2010, when the legislation was passed, some provisions have already been implemented, resulting in previously uninsured Americans obtaining health coverage. However, major provisions of the law will not be implemented until 2014.

Volunteers in Medicine (VIM) clinics will continue to be critically important safety-net health care providers, both before and after the 2014 implementation date. Since the law was passed, as health care costs have continued to escalate at an alarming rate, more Americans have lost their health insurance and joined the ranks of the uninsured. Experts agree that even when millions of people are able to purchase affordable insurance as a result of the provisions in the ACA, there will still be millions of people who do not qualify for, or are excluded from applying for subsidized insurance. Those people will continue to rely on Volunteers in Medicine safety net community-supported clinics for their health care.

States have significant power to shape Medicaid programs, and between now and 2014, preparation for implementation of the ACA among states will have enormous variability, and depend on a state’s commitment to fund Medicaid subsidies for lower income residents to purchase health insurance through “exchanges”. The insurance products offered through exchanges will vary greatly in cost and coverage. Based on the successful Massachusetts experience (on which the ACA legislation is modeled), helping uninsured people apply for and secure health insurance will take years to “ramp up”, especially since states continue to have serious shortages of primary care physicians. Initially, people may qualify for health insurance, but many will be unable to secure a primary care physician, leaving them insured but without access to care. VIM clinics will be needed for years to continue to provide care to those transitioning from being uninsured into having affordable health insurance coverage AND access to care. Undocumented residents are excluded from purchasing health insurance coverage under the ACA, and are welcome to receive care at most VIM clinics.

Community-owned and sustained VIM clinics will be needed indefinitely to continue to care for those who remain uninsured, who fall through the cracks or are unable to afford services not covered by their insurance. The community’s ongoing investment in a VIM clinic assures access to quality, low cost medical care for those most in need in a caring, dignified environment, so that everyone in a community has access to health care, and in doing so, the health of the community improves, and the common good is well served.

June 28, 2012

Clackamas VIM continues to expand our service hours to serve our patients more quickly.
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