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Health care: For poorest patients, insurance isn’t an option

By Jason Lesley
Coastal Observer

Anne Faul, executive director of Smith Medical Clinic, says the new federal health insurance law will have almost no effect on the need for medical services among the poor in South Carolina.

She estimated that less than 3 percent of the Smith clinic’s clients will be helped by the Affordable Care Act.

“Many people,” she said, “are under the mistaken impression that the ACA will provide insurance for all. The truth is that since South Carolina is one of 26 states that have elected not to expand Medicaid, there will be very little impact for our patients, 97 percent of whom fall below 138 percent of the federal poverty level. So, unfortunately, the services of a free clinic will be needed just as much as ever.”

Linda Bonesteel, director of the Georgetown Community Care Network, agrees that expanded health care is “off the table” for the poorest of the poor in the state under the Affordable Care Act, but the working poor who want health insurance may have options.

Bonesteel said Georgetown Memorial Hospital, in cooperation with the Community Care Network and its benefactor, the Duke Endowment, is in the process of training counselors to help people between the ages of 19 and 64 find affordable health insurance.

“We will try and align the available resources for people needing access to health care,” Bonesteel said, “linking transportation and affordable medications. We will work to explore the options available, and that person makes the decision whether they want to opt in or out. Ours is an advocacy role. We can’t direct them to a plan. We help them find assistance.

“Everyone is in the process of ramping up to find those subsidies. Every client would be different. That is the unique work when you look at a plan with an individual in front of you.”

At the very least, she said, counselors could show individuals who qualify under poverty guidelines how to avoid paying federal penalties on their income tax forms. It’s $95 next year and goes up in the future.

Bonesteel said poverty doesn’t matter in determining eligibility for insurance. There is not an individual means test for Medicaid. It is available only to pregnant women, children and the permanently disabled. The majority will continue to seek care at places like the Smith Clinic in Pawleys Island and St. James-Santee Family Health Care in Georgetown.

Faul said Smith Medical Clinic, which operates through Holy Cross-Faith Memorial Episcopal Church on Baskervill Drive, will continue to provide care for a patient at a cost of less than $250 per year.

“People are amazed when they hear that $250 number,” said Charlotte Moore, clinical director. “It’s all possible because of over 180 volunteers and the strategic partnerships we have with other non-profit agencies and, of course, our enduring partnership with Georgetown Hospital System.”

The clinic receives no federal or state funding. Continued operations rely on donations from patients, private foundations and people in the community.

“What we do would not be possible without the support of this community,” Faul said. “Donors have embraced our Patient Partner Program, where a $250 donation can provide complete medical care for a patient for a full year.”

Patients also donate when they are able. Faul said she is proud of the fact that patient donations represented nearly 10 percent of last year’s total budget.

“I know patients appreciate the care that they receive at the clinic, she said, “and they give us as much as they are able.”

Recently, the clinic received a $100 check in the mail from a former patient with a note that said, “I didn’t always have money to throw in the basket when I was a patient. This donation is from my first paycheck in over three years. You saved my life.”

To learn more about Smith Medical Clinic go online to smithfreeclinic.org or contact Faul at 843-237-2672.

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