The Greene County Care Clinic, the county’s free clinic, decided just last week it would not close its doors. The clinic has struggled for the past few months to decide where it fits now that Virginia has approved Medicaid expansion.

Virginia’s Medicaid system is expanding with the new year, offering insurance to an estimated 400,000 throughout the state. Virginia estimates about and additional 800 Greene County residents will now qualify for Medicaid.

The clinic’s board of directors even considered closing, until research was released showing there will still be a large number of uninsured in Virginia who need services, said Janet Call, the nurse practitioner who founded the clinic in 2005.

“The research from the Virginia Association of Free and Charitable Clinics showed there could be 400-600 additional people who will benefit from our clinic,” Call said. “There is still a need.”

A late-night ruling on Friday by a federal Texas judge ruled core provisions of the Affordable Care Act are unconstitutional, including the mandate that everyone have insurance or face a penalty.

Call said this will probably cause many working families to drop insurance because the cost of it is expensive.

“Many families cannot afford the deductible so they cancel their insurance,” Call said. “They’re paying this high deductible each year before their insurance even kicks in and still paying premiums each month. The question was can we serve these people?”

Because of that, Call said, the clinic will be raising the upper income limit “to capture those who are working but in jobs that don’t have health care or affordable health care.”

The Virginia Association of Free and Charitable Clinics is a clearing house for statistics from the more than 60 free and charitable clinics across the state. It found there will be about 300,000 across the state who won’t meet the income requirement to qualify for Medicaid.

“One thing that people don’t realize to qualify for Medicaid expansion for one person you have to be below 16,000 a year,” Call said. “Many of our patients are working in service-type jobs that just don’t offer healthcare or full-time work. The work is out there, there is no doubt about it, people are getting work, but the problem is the insurance is not there. It’s getting tougher for people to get healthcare.”

Call said the Greene Care Clinic offers a lot of chronic disease management at its office. The number one reason for a visit is hypertension, two is diabetes and three is mental health, she said.

Additionally, the clinic does checkups for acute conditions, too.

“We can do anything that’s being done in a family practice,” she said.

Additionally, the clinic offers medication assistance, Call said.

“I believe there’s been a misconception all these years that you couldn’t have any income to come to the clinic,” Call said. “What we’re trying to get the word out is that it’s not true. We want people who have income of some kind to call us to see if they qualify. Give us a chance to provide the care they’re probably going without.”

The Greene County Care Clinic is a private clinic, she said.

“We get a very small amount of money from the state but we’re not subsidized by the government,” Call said. “We depend on donations and can offer state tax credits that are a direct subtraction from state income taxes for donations of $500 or more, but they must be in by Dec. 31.”

Call said Medicaid expansion does mean more healthcare for people but it will not achieve coverage for all.

“Clinics will continue to be there for those who lack insurance and healthcare options,” Call said. “Free clinics are not the solution for our healthcare problem, they but they are a safety net.”

The Greene County Care Clinic is at 39 Stanard St. in Stanardsville. Office hours are 9 a.m. to noon Monday, Tuesday and Thursday and from 13 p.m. on Wednesdays.  Call (434) 985-7000 for an appointment or more information.

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