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California’s Community Clinics, Big ACA Beneficiaries, Worry About Their Future

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Paula Wilson has seen some tough times in her 23 years as the CEO of Valley Community Healthcare, a clinic that provides care for the poor in North Hollywood, Calif. But nothing was quite like Nov. 9, the day after the U.S. elections, when walking around the office “was like coming into a funeral,” she said.

Her staff worried that a repeal of the Affordable Care Act, long promised by Republicans, would obliterate their jobs. Patients fretted it would jeopardize their care.

Nearly a third of the clinic’s 25,000 patients were newcomers, many of them recently covered through the expansion of Medi-Cal ushered in by the Affordable Care Act. Thanks to the expansion, Valley Community Healthcare had been growing rapidly, opening one new site, adding on to others, and offering patients new dental and mental health services.

What would happen if this new source of financial support were taken away?

Wilson didn’t have an answer that day, and she still doesn’t. But she’s hanging on to a cautious hope. “Pretty much that whole first week was getting a grip and assuring people: We’ve been here 46 years and we’re not going anywhere,” she said. “We’ve fought the fight before, and we’ll do it again.”

In the absence of details about the impact and timing of a possible ACA repeal, Wilson’s brand of determination is all community clinics can count on for now.

Use Our Content This story can be republished for free (details).

Republicans, newly empowered by Donald Trump’s ascendance to the White House, have made clear they plan to repeal large parts of the landmark health care law in short order. The timing of any replacement is still uncertain, though political pressure has been growing recently for any void left by a repeal to be quickly filled with a new plan.  For the time being, however, consumers are unlikely to see big changes in their health care.

Community clinics are key providers of primary care services for the poor. CaliforniaHealth+ Advocates, which represents the state’s clinics, estimates that they serve 6.2 million Californians — an increase of more than a million in less than five years. Today, more than 3.5 million community clinic patients are covered by Medi-Cal, California’s version of Medicaid, the federal health insurance program for people with low incomes.

More than half of patients who signed up for Medi-Cal after the advent of the ACA have gotten their primary care at community clinics,

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