Virginia's Free Clinics are Facing an Influx of New Patients; Proposed State Budget Amendments Could Help Meet the Need
An estimated 300,000 Virginians will become uninsured by 2027; the healthcare safety net needs stabilization in order to provide services to them.
By Adele Uphaus
MANAGING EDITOR AND CORRESPONDENT
Email Adele
Budget amendments being considered in the General Assembly could result in an increase of between $10 million and $15 million in annual funding for Virginia’s free and charitable clinics.
That would be “a step in the right direction,” but is “not by itself going to solve the huge challenge of taking on hundreds of thousands of more [uninsured] patients,” said Rufus Phillips, chief executive officer of the Virginia Association of Free and Charitable Clinics (VAFCC), in a phone call with the Advance last week.
According to a June analysis by the federal Joint Economic Committee, about 306,000 Virginians stand to lose their health insurance due to the expiration of the Affordable Care Act subsidies and the changes to Medicaid that will go into effect in 2027 as a result of H.R. 1.
“Right now, our 70 member clinics through the state serve a total of 113,000 vulnerable Virginians, so to try to take on a lot more uninsured patients is going to be difficult—really, frankly, impossible—without some increase in funding from the state,” Phillips said.
In the State Senate, Mamie Locke (D-SD23) is sponsoring a budget amendment that would increase funding for free clinics by $10 million. Del. Rodney Willett (D-HD58) is sponsoring an amendment that would increase funding by $15 million.
The budget currently in place provides a total of $8.8 million in funding to the state’s free and charitable clinics, Phillips said.
“Right now, across all our clinics, if you averaged the cost of care for an uninsured patient, it’s roughly $1,000 per year,” he said.
That means the $8.8 million currently allocated to free clinics covers the cost of care for just 8,800 patients—a small portion of the 113,000 vulnerable Virginians (72,000 of them uninsured) that receive care at the clinics.
The $15 million increase would mean the clinics could serve 15,000 additional patients—still far short of those who need the free clinics now and not counting the predicted wave of uninsured patients that’s coming, but a step towards stabilization, Phillips said.
“Our hope is that in working with [Governor Abigail Spanberger’s] new administration over the next few years, perhaps a sort of bigger solution can be achieved in stabilizing the overall safety net and enabling it to take on this huge increase in uninsured that is anticipated,” he said.
That safety net—which includes free clinics as well as federally qualified healthcare centers and hospitals, particularly in rural areas—has already been stressed in recent years, Phillips said, due to an increase in operating costs and overall demand for free clinic services, which has increased “by over 40% in the last couple of years.”
The safety net in the Fredericksburg area became more stressed last year with the closure of the Lloyd Moss Free Clinic, which treated 3,000 patients—more than 400 of them uninsured.
Theron Stinar, a family physician and chief executive officer of Fredericksburg Christian Health Center (FCHC), said the clinic has taken in about 240 former Moss patients.
“I know that every day, there’s a least one or two new patients on the schedule,” he said
In the past year, FCHC—which provides primary care, behavioral health care, and nutrition services—saw just under 3,100 patients, Stinar said. Of those, 1,224 were uninsured or under-insured.
Stinar said that in recent months, the trend has been back towards “more uninsured patients and not as many patients on Medicaid” as in previous years, and “absolutely, we are expecting to see more.”
“A lot of patients that were immigrants that previously had qualified for Medicaid now won’t be able to or will be afraid to reapply,” he said. “So we expect to see that, and also [to see] people who had financially qualified and no longer qualify, or people who were unable to have a meaningful employment and are now required to work.”
Phillips said that aside from Moss, no other clinics in VAFCC’s membership have closed, but “many are running operating deficits and they can’t run those forever, so we’re going to have to solve that.”
“I hate to put it this way, but it’s not like we really even have a safety net—it is so stressed,” he said. “There are a lot of people falling through as it is, and here we go with this incredible challenge [the end of subsidies and cuts to Medicaid].”
Colorado last year established a new revenue stream that will provide $100 million over the next three years to safety net healthcare providers. The money comes from “interest on the state’s unclaimed property trust fund, foundations, and matching federal dollars,” according to CBS News Colorado.
Phillips said Virginia may need to think about enacting something similar.
“It’s tough to conceive how exactly the state is going to be able to [stabilize the safety net] without taking steps like Colorado has,” he said.
Stinar said free clinics such as FCHC are crucial to the health of the entire community.
“You care about the individual person, of course, but if you look at the community at large, a lot of [clinic patients] are people who are in our community working,” he said. “They’re [your restaurant staff] or your car mechanic or your Uber driver or your childcare provider. If you have 10% of working people who can’t get healthcare, and they’re sick and calling out, or they’re choosing between food or taking care of a health problem—that has a significant impact on the whole community at large.”
This story was updated on January 27 at 11: 20 a.m. to clarify how many patients currently receive care at Virginia’s free and charitable clinics and to fix an incorrect last name.
Local Obituaries
To view local obituaries or to send a note to family and loved ones, please visit the link that follows.
Support Award-winning, Locally Focused Journalism
The FXBG Advance cuts through the talking points to deliver both incisive and informative news about the issues, people, and organizations that daily affect your life. And we do it in a multi-partisan format that has no equal in this region. Over the past year, our reporting was:
First to break the story of Stafford Board of Supervisors dismissing a citizen library board member for “misconduct,” without informing the citizen or explaining what the person allegedly did wrong.
First to explain falling water levels in the Rappahannock Canal.
First to detail controversial traffic numbers submitted by Stafford staff on the Buc-ee’s project
Our media group also offers the most-extensive election coverage in the region and regular columnists like:
And our newsroom is led by the most-experienced and most-awarded journalists in the region — Adele Uphaus (Managing Editor and multiple VPA award-winner) and Martin Davis (Editor-in-Chief, 2022 Opinion Writer of the Year in Virginia and more than 25 years reporting from around the country and the world).
For just $8 a month, you can help support top-flight journalism that puts people over policies.
Your contributions 100% support our journalists.
Help us as we continue to grow!
This article is published under Creative Commons license CC BY-NC-ND. It can be distributed for noncommercial purposes and must include the following: “Published with permission by FXBG Advance.”