Rx in the City 2012
The New Medical Landscape

Left in need? How Obamacare & Rick Perry's Medicaid rejection hit safety-net clinics like San Jose

Left in need? How Obamacare & Rick Perry's Medicaid rejection hit safety-net clinics like San Jose

San Jose Clinic_building
The San José clinic was founded in 1922 to bring coverage to the underserved community. Courtesy of San Jose Clinic
Paule Anne Lewis_San Jose Clinic
Executive director Paule Anne Lewis hoped that Medicaid expansion in Texas would increase coverage for the more than 1 million uninsured Houston-area citizens. Courtesy of San Jose Clinic
San Jose Clinic_building
Paule Anne Lewis_San Jose Clinic

Armed with a meager $50 operating budget, courtesy of the Charity Guild of Catholic Women, and a lofty vision, conceived of by Monsignor George T. Walsh, the San José Clinic opened in 1922 to provide health access to Houston's underserved community.

Ninety years later, that safety net clinic provides primary and sub-specialty care, dental, vision, pharmacy access and laboratory services for individuals without health insurance. It has affiliations with two dozen area colleges and hospitals, running on donated medications and supplies, volunteer manpower and philanthropic dollars.

Although San José Clinic accepts neither private insurance nor government-subsidized programs like Medicare and Medicaid, executive director Paule Anne Lewis realizes that the recently-upheld Affordable Care Act has implications for the charity clinic.

 "If we would have had Medicaid expansion . . . approximately one-quarter of my patient population would have had additional coverage," Lewis tells CultureMap. 

This is why: A nationwide recession like the current one hits the clinic twice over, garnering increased need (jobless citizens seeking free health care) and seeing decreased support (donors cutting back on gifts).

San José must raise approximately $115 per patient per visit; the clinic sees approximately 30,000 patients a year, and that number is growing.

Gov. Rick Perry recently rejected the act's Medicaid expansion — which would have extended the program to families earning less than 133 percent of the federal poverty level (that 133-percent figure is currently $30,657 per year for a family of four with the poverty level at $23,050) — on behalf of the state.

"If we would have had Medicaid expansion . . .  approximately one-quarter of my patient population would have had additional coverage," Lewis tells CultureMap.

That would free up services and time for other patients, decreasing the wait time and likely increasing the effectiveness of treatment.

"We're absolutely stretched thin," Lewis admits, but that won't stop San José and its cadre of practicing physicians, retired doctors and community volunteers from providing for those in need.

"It's important to remember that San José [has been around for 90 years using] pretty much the same model," Lewis says. "We will be here as long as there are people willing to respond to that need."