NEW PORT RICHEY
Michell Doganis limped through the waiting room, her right leg in a brace.
"It hasn't been healing right," said Doganis, a 39-year-old New Port Richey resident. She broke it in a fall. A diabetic, she also suffers from numbness in her feet, which makes walking difficult. "It's been almost a year. It should have healed by now."
Doganis has been coming to Good Samaritan Clinic since she lost her job as an office clerk for a cab company in 2008. In addition to diabetes, she is treated for high blood pressure. And she suffers from periods of depression.
Like many Floridians, Doganis has been unable to log onto the Healthcare.gov website to see if she qualifies for a subsidized health plan under Obamacare, the Affordable Care Act. She doubts she will. Her husband makes $13 an hour as a cook, but the restaurant cut his hours to avoid health insurance requirements.
"We're thinking about moving back to New York because we can get free Medicaid there," she said. If not for Good Samaritan, "I don't know what we would do."
Dubbed "Good Sam" by its staff and patients, the clinic next to the old Community Hospital has provided health care to the uninsured since 1990. The waiting room is typically packed, and this Wednesday afternoon is no exception. Those who run the clinic expect that to continue despite the Affordable Care Act, which will provide health insurance to many who can't get it through their employers or government programs such as Medicaid.
But a loophole leaves millions behind. A New York Times analysis estimated 150,000 in the Tampa Bay area would not be able to get coverage in the marketplaces created by the law. Of those, 29,367 live in Pasco County.
"We won't be closing our doors," Good Samaritan director Melissa Fahy said. "There's still going to be a tremendous need."
She said a top donor recently said checks might stop coming after Jan. 1 when the law takes effect. Fahy quickly explained about the gap.
Here's how it happened. The health care law does not allow those who fall below the poverty line to buy a subsidized health plan because it assumed they would receive coverage under expanded Medicaid programs. But the U.S. Supreme Court ruled that states could opt out. Florida is one of 26 states that refused to expand Medicaid. The decision causes about 1 million Floridians to fall through the cracks.
"All of a sudden this leaves an almost gray zone," said Nicole Lamoureux, executive director for the National Association of Free and Charitable Clinics, a nonprofit advocacy group that represents 1,200 clinics across the United States. "There's a very large crack at this point in time."
Pat Hill is likely among those falling through that crack.
Hill, 56, lost her job as a secretary for a property management company in 2007 during the housing bust.
"I even went back to school to do hair," she said. But extreme numbness in her hands left her unable to hold a blow-dryer.
Her husband works part-time at a plant nursery to help pay the bills. Their income is about $1,200 a month. She watches her 2-year-old grandson for her daughter, who works part-time and lives with her parents.
"We're part of that group that's struggling," she said.
David Janssen doesn't even plan to apply for Obamacare, figuring it will be a waste of time.
"I think it's all a crock," he said.
Janssen used to be a thriving construction worker. He never had health insurance but was lucky. Now, at 49, age is starting to creep up. Janssen, who works part-time at Pizza Hut, comes to Good Samaritan for help with high blood pressure, high cholesterol and a nagging foot pain called plantar fasciitis.
"There's got to be something for folks who are on hard times," he said.
The people in the waiting room worry that they will face fines if they don't buy a health plan. With few exceptions, the law requires everyone to have health insurance.
"That's all I need — to have to pay money every year to not have health insurance," said Karol Bushkofsky. The 63-year-old diabetic heart patient lives on $980 a month from Social Security. After she pays for her car and utilities, she has about $300 left for food.
She has no children, so she does not qualify for Medicaid. (Florida excludes most childless adults from Medicaid, no matter how poor they are.)
She said she has tried to find work, but no one will hire her.
Even if many of these patients were to get insurance cards, a plan is good only if it's used, Fahy said. Some of Good Sam's patients face additional barriers such as lack of transportation or an inability to afford prescription medication.
The clinic provides bus passes for those without a ride. An on-site pharmacy provides free meds. One patient's 90-day supply of medications would cost more than $2,000 retail. The clinic also has limited dental services that include fillings and extractions.
But it's the intangibles the clinic provides that make a difference, Fahy said. If patients miss appointments, a nurse will follow up with a phone call. And she said responses on comment cards are 99 percent positive.
"Sometimes our patients need a little extra attention," she said.
Lisa Buie can be reached at firstname.lastname@example.org or (813) 909-4604.