Health Ministries and Local Churches

November 25th, 2013

Stories of Healing and Healers

“Beverly” is a 61-year-old married woman who works in retail sales. Her husband, a software engineer, lost his job in the recession several years ago and is now fighting cancer. Her job doesn’t provide insurance, and they can’t afford private insurance from the salary of his home-based business. Once Beverly found the services of Agape Clinic, housed at Grace United Methodist Church in Dallas, Texas, she was able to get treatment for high blood pressure, anxiety, insomnia, and pain. Because she and her husband own their home, they don’t qualify for subsidized care at the county hospital, despite their limited income. Agape Clinic, started in 1983 by a few individuals motivated by compassion and vision, now sees 8,000 patients a year. Their volunteer doctors and nurses seek to live out the example of Christ by offering care to all who seek healing.

Volunteers at the Gallatin C.A.R.E.S. (Christian Association for the Relief of Economic Suffering) Center outside of Nashville, Tennessee, felt called to do more than just help clients with financial assistance. They wanted to provide for their spiritual and health needs as well. Before long, prayers were answered; and a local, licensed United Methodist pastor started a worship center for this low-income community. More prayers were answered when a nurse practitioner helped start a free health clinic with a grant from the Tennessee Conference of The United Methodist Church. The nurse sees patients several hours before worship starts and helps them with basic health screening and health education needs. Clients are welcome, but not required, to stay for worship and a free meal. “We want to care for the whole person and help them become healthy spiritually, physically, and emotionally,” said Whitney Simpson, a ministry team member.

“Anton,” a resident of Washington State, has been receiving care for his high blood pressure from the Edmonds Mobile Medical Clinic, which comes to Edmonds United Methodist Church every Tuesday morning. The mobile clinic, supported financially by the church and other community groups, utilizes interpreters who can communicate with Anton in his native language and refer him to other health resources. The mobile clinic meets basic health needs of lower-income uninsured neighbors in this diverse community, which has a large population of Spanish, Russian, Mongolian, and Arabic speakers.

The Uninsured and the Underinsured

The faces of the uninsured vary—from the young working single mom, to the college student, to the middle-aged man who’s not old enough to qualify for Medicare (the federal health insurance program for Americans aged 65 and older and younger people with disabilities). Medicaid is also a federal medical program, but it is primarily for low income Americans. However, since each state can decide what eligibility requirements it wants to establish, coverage for Medicaid varies. For example, many low-income adults living in Texas do not qualify for Medicaid unless they are pregnant, aged, blind, or disabled. The idea of a health safety net for the poor is actually a myth in many states.

According to the Kaiser Commission on Medicaid and the Uninsured, almost 48 million nonelderly Americans did not have insurance in 2011. The commission claims that the uninsured share five characteristics:

(1) Most have low or moderate incomes. Federal guidelines put a family of four at 100 percent of the poverty level if the family income is $23,500 or less a year (see sidebar on page 3 for more information on the federal poverty level).

(2) More than three quarters are in a working family, but either they aren’t offered employer-based insurance or they can’t afford the premiums.

(3) Many of these families can get coverage for their children through Medicaid or the Children’s Health Insurance Program (CHIP), but the adults are often ineligible.

(4) About 25 percent of uninsured adults go without needed care due to cost, compared to only 4 percent of those who have private insurance. Since they are less likely to receive preventive care and services for major health conditions, this leads to more serious health problems and higher mortality rates.

(5) Medical bills are a burden for the uninsured and often leave them with debt. When they receive care, the uninsured pay for more than one third of their care out of pocket and are frequently charged higher amounts than the insured pay.

Some patients who seek assistance at free clinics have insurance, but they are considered underinsured because their health coverage does not adequately protect them from high medical expenses. For example, their coverage might not cover certain conditions, or they might not seek primary care due to a high co-pay or high deductible.

Federal Health Care Reform: Who Will Remain Uninsured?

The first answer to that question is, It depends on what state you live in. The second answer is, No one really knows. The Affordable Care Act (ACA) proposes to make health coverage affordable by creating consumer protections, expanding Medicaid, and providing financial assistance to help people purchase private coverage. Some states will reduce the uninsured by expanding Medicaid, with most of the expansion costs paid for by federal funds. States can also help those not eligible for Medicaid but below 400 percent of the poverty level ($45,960 for one person) with subsidies to purchase private insurance through newly created insurance exchanges. According to the Congressional Budget Office, health care reform could reduce the number of uninsured individuals by 27 million between 2014 and 2023.

However, since the Supreme Court ruled in June 2012 that states can opt out of Medicaid expansion and state-run exchanges, it’s unknown who is likely to remain uninsured once the ACA goes into effect in January 2014. As of this writing, 14 governors have announced their intention to opt-out of Medicaid expansion, 6 are undecided, 3 are leaning against, and 2 are leaning toward expansion. This will affect who does and does not remain uninsured. For example, in Colorado, state leaders are actively encouraging residents to enroll in the state’s new insurance market titled “Connect for Health Colorado.” The state is also expanding Medicaid. By contrast, in Missouri, state officials have voted against expanding Medicaid and creating a state-run market. While residents can still participate in a federally run exchange, it has no publicity presence in the state; and information about it is difficult to find. That means many of Missouri’s 850,000 uninsured residents will continue to live without health coverage.

Regardless of how states respond to the federal law, upwards of 31 million people might still be uninsured according to one analysis, the majority of those (80 percent) US citizens. Only 20 percent of the uninsured would be non-citizens, some of whom are legal residents.

An association of free clinics in Michigan (a state that is likely to expand Medicaid) believes that the need for such clinics will continue. Some people will be exempt from the mandate, and some will choose to remain uninsured. Both legal and undocumented immigrants will likely need health care assistance, as will citizens without documentation. The association found that in states like Vermont, Wisconsin, and Massachusetts, where Medicaid has already been expanded, the volume of free clinics continued to grow because of the shortage of primary care doctors who will accept Medicaid.

How Churches Can Help

There’s no denying that federal health care reform legislation has complications, controversy, and risks. But churches that have committed to helping the poor and uninsured with health needs have decided to look beyond politics and follow what they believe to be a command from Christ to care for the least and lost, regardless of circumstances.

The Church Health Center in Memphis, a ministry that promotes healthy bodies and spirits for all by providing health care for the working uninsured, also believes needs will remain. “If anything we’re expanding to meet the growing needs of our community and to address things not covered by the Affordable Care Act such as adult dentistry, behavioral health and prevention,” said CEO Dr. Scott Morris, an ordained United Methodist minister. The center’s website states, “Today’s healthcare landscape is ever-changing, but as people of faith responding to God’s call to heal, we are committed to moving to where the needs are and filling the gaps.”

When Dr. Barbara Baxter started the Agape Clinic in the basement of Grace United Methodist Church, it was hardly an ideal place to treat patients. She walked down the stairs, through a dark hallway past moldy pipes, to enter a 12-foot by 13-foot closet-sized room with a single light bulb, exposed wires, and no sink. Now Agape Clinic is set to celebrate its 30th anniversary. With support from United Methodist churches, the clinic has expanded to 11 nicely equipped exam rooms and a large waiting area. In addition to basic primary medical care, they offer specialty services in women’s health, neurology, pediatrics, dermatology, asthma, allergy, ophthalmology, and some counseling. Lab and prescription services are also offered. Agape Clinic provides over three million dollars of care on an operating budget of $375,000. The clinic does not accept insurance of any kind but instead relies on donations and fundraising. More than a third of donations come from the patients themselves, who want to pay but can’t afford traditional health care.

“It’s the story of the mustard seed,” said Stephanie Bohan, executive director of the clinic. “What started as a small dream has turned into a meaningful vision. We don’t expect the need for health services to diminish, and we will continue to offer care to as many in our community as we can, out of service and out of unconditional love.”

Be sure to check out FaithLink, a weekly downloadable discussion guide for classes and small groups. FaithLink motivates Christians to consider their personal views on important contemporary issues, and it also encourages them to act on their beliefs.

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