What will be the impact of ACA on FQHCs and other venues for the underserved?

[Pachinko]

(Sorry for all the acronyms)

The Affordable Care Act lowers the threshold for Medicaid and makes commercial insurance available for more people. This could mean that patients currently seen at community clinics (like federally qualified health centers) or county facilities will migrate to private providers or other practice settings. Do you think that CCs will see dips in their patient loads? Who will be left? Lastly, has anyone who works at underserved facilities seen this happen already?

[Corey Narry, MSN, RN, NP]

I think it's too early to see the effects. I live in San Francisco and prior to ACA, the city and county already had it's own version of ACA (Healthy San Francisco) for those unable to afford commercial insurances or doesn't have employment coverage.

Those insured by them actually go to the county hospital (SFGH) and various other clinics in the city including some FQHC's. They get referred to tertiary hospitals in the city if their condition warrants it. Now that we have Covered California, I think some will stay with with Healthy San Francisco as an option. I think people who availed of services before will continue to go to the places they went to out of familiarity.

Of course, we're just a small portion of the California population. However, you're right that some people now have private insurances that are quite a jump from what they didn't have before. A friend who is a struggling artist (hence, not insured previously) now has Kaiser Insurance, considered good in these parts because of the well coordinated network of Kaiser facilities. But then he is well and never really needs healthcare that much.