IndyWeek – June 22, 2022
Lincoln Community Health Center in Durham always seems to be bustling. The patients drifting in and out of the clinic’s main location on Fayetteville Street offer a snapshot of the city’s lower-income population: a mix of Black, white, and Latino residents who are there for low-cost medical, dental, mental health, or pharmacy services.
Heidi Flores is just leaving the facility. With her T-shirt, cutoffs, and shy smile, she looks like the young woman on the precipice of adulthood that she is. She was here for a checkup.
“It was my first checkup, actually,” says Flores, who just turned 20. She doesn’t have health insurance and had been worried about how much a visit to a primary care provider might cost. She’s seen her aunt receive bill after bill following medical visits. In response, Flores, like several of her friends, has simply stayed away.
But the health center charges on a sliding scale, and the appointment only cost her $20. Happily, everything looked fine on this visit, though she had some blood work done and is waiting on the results. Flores says she’d definitely come more often if she had health insurance.
Flores—and roughly 600,000 other low-income North Carolinians—may be in luck. Early this month, the North Carolina Senate overwhelmingly approved a bill that would expand Medicaid for people earning up to 138 percent of the federal poverty level, or about $18,000 for an individual. After almost a decade of resisting Medicaid expansion, the senate’s vote was historic. But it wasn’t decisive: to become law, the bill must still pass the state house of representatives, where the reception is likely to be much chillier.
No group arguably stands to gain as much from Medicaid expansion as community health centers and their patients. Located across the state, these mission-driven nonprofit clinics, also known as federally qualified health centers (FQHCs), are legally obligated to accept everyone regardless of ability to pay. They see roughly 560,000 North Carolinians; the vast majority are poor, and 40 percent lack health insurance.
In the Triangle, four community health organizations run a total of about 27 clinics, reaching from Louisburg, located just east of Wake County, to Siler City in western Chatham County. Each one is a little different, but generally they all offer primary care to adults and kids, dental care, and some mental health services.
The clinics and their patients—more than 100,000 Triangle residents—would vastly benefit if Medicaid were expanded.
“We see a very sick population,” says Claretta Foye, Lincoln’s CEO. “Diabetes, hypertension, COPD, asthma—a lot of our patients have all of those.” Those chronic conditions are best managed through preventive care and regular checkups, but over half of the center’s patients lack health insurance or are “under-insured,” paying for lab tests or specialists out of pocket. And with inflation spiking, even $20 to see a provider can be prohibitive.
The result is patients who wind up much sicker, often needlessly so. Problems that could’ve been prevented early on may blossom into full-blown crises—and patients, with little recourse, may wind up at the emergency room.
If you are a member of the news media and would like to learn more about the mission and work of North Carolina’s community health centers, or wish to interview a health center professional or patient, please contact:
Stacie Borrello, Communications and External Affairs Manager
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