Health Care Access Clinic is proud to provide high-quality health care to our county’s uninsured, low-income residents. We think everyone in this community, including our patients, deserve to be cared for in a respectful, holistic way that makes them feel like coming back.

That is why we became a Patient Centered Medical Home and why we provide integrated services like medication assistance and mental health counseling. So, when we hear cries that maybe our resources would be better spent signing individuals up for insurance on the Affordable Care Act’s marketplace, we scratch our collective heads. It is true that there may be a patient here and there that has “not gotten around” to researching if they can buy insurance on the health insurance marketplace. However, we devoted considerable resources to providing our eligible patients with the necessary resources to sign up for insurance. We trained one of our staff to be an ACA navigator and she devoted precious clinical time to answering phone inquiries, as well as meeting with patients in the clinic who wanted to know more about the ACA.

We also directed patients to other community navigators at our collaborating health centers. In short, we did our best to get people interested in buying insurance headed in the right direction. After all, if a patient is able to buy insurance they will move on to treatment elsewhere which opens a place up for an uninsured person.

It is critical to remember that buying insurance on the marketplace was made affordable by offering subsidies to people earning between 100 percent and 400 percent of poverty. We treat patients with incomes of 0 to 185 percent of poverty (up to $1,799 a month for a single adult.) Fully 61 percent of our patients in 2013 were below 100 percent of poverty and thus not eligible for a subsidy on the health insurance marketplace, and so insurance is still out of reach.

Moreover, as long as Kansas does not expand Medicaid, patients below 100 percent of poverty will not have a viable option for insurance and so need us. We never lose sight of the fact that we are the only thing standing between our poorest patients and access to care.

There will always be a few individuals who elect not to take advantage of insurance when it is made available and affordable to them. For them, the decision isn’t between insurance and using Health Care Access Clinic because it’s easy and cheap. If Health Care Access weren’t here they likely would still be uninsured, they’d just be using the emergency department at Lawrence Memorial as their primary care office instead of us.

We are all in this together and we must work together if we are to solve the problem of allocating scarce community resources in a way the benefits the neediest patients with the fewest options. Sometimes that means continuing to take care of a patient who established care with us more than five years ago and who is reluctant to change.