Free clinics are often overlooked as a part of the U.S. health care safety net because they do not accept government reimbursement for their services, are operated predominately by volunteers, and almost exclusively serve uninsured individuals. They can generally be described as private, tax-exempt non-profit organization that provide medical, dental, mental health, and/or pharmacy services directly to patients at little or no cost. They are distinct from federally qualified health centers (FQHCs), “which receive federal funds, provide billed services to Medicare and Medicaid patients, and offer sliding-scale fees to their uninsured clients” (Swan, 2016, p.471).
The Patient Protection and Affordable Care Act of 2010 (ACA) was predicted to have broad impacts on the American health care system, including a significant reduction in the number of uninsured individuals—the populations served by free clinics. The ACA’s primary strength was to “reduce the number and proportion of uninsured individuals’ to expand Medicaid to 133% of the federal poverty level (FPL)” (Swan, 2016, p.471).
The research question examined is how Patient Protection and the Affordable Care Act of 2010 may dramatically affect the demographics of the uninsured population and the funding prospects for free health clinics? The demographics of the uninsured population “are expected to shift, as a result the ACA, with a disproportionate number of uninsured individuals being younger and/or undocumented persons” (Swan, 2016, p.472). North Carolina is a model state to study how ACA affects free clinics of any state, and it has a statewide association to serve and lobby for their interests.
The data used in the study were survey items related to the ACA which was developed by reviewing the ACA legislation that specifically pertains to free clinics (eg, high-risk pool, expansion of Medicaid, survey times, included both knowledge and perception questions. These questions were developed in partnership with NCAFC (North Carolina Association of Free Clinics) staff members, “who fielded questions and concerns from executive directors regarding the ACA’s impact on free clinics” (Swan, 2016, p.474), and questions were reviewed by a NCAFC board member and free clinic executive director to ensure they reflected understanding and misperceptions of the ACA.
The study in this research was quantitative. They utilized a survey to quantify the problem by way of generating numerical data that can be transformed into useable statistics. Descriptive statistics (means and frequencies) were computed for all items in the survey.
The sampling method used to describe the data was stratified sampling. Stratified sampling is where...