How a community clinic in a poor D.C. neighborhood reacted to the Supreme Court decision

June 28, 2012

Paula Stewart, 49, hasn’t heard much about Obamacare, and she greeted the news of the Supreme Court's decision this morning with a shrug. But the HIV-positive D.C. resident credits one local beneficiary of the Affordable Care Act for saving her life.

"I'm 30-years positive. I'm an addict," said Stewart, who just left the waiting room of the Family and Medical Counseling Service. She's been receiving treatment there since she got out of jail, not only for HIV, but also asthma, diabetes, and bipolar disorder. "I've got the best health care ever seen in the world," she asserted.

The community health clinic sits just across the river from the Capitol, in D.C.'s predominantly black Anacostia neighborhood. On the third floor of a big brick complex on Martin Luther King Jr. Boulevard, the clinic isn't much bigger than a typical doctor's office. The small white waiting room is plastered with educational posters on diabetes and Hepatitis C, chock full of pamphlets on HIV and a dozen blue chairs. The Family and Medical Counseling Service isn't free, but it has a sliding fee scale, and patients who are uninsured and can't afford to pay still receive care. And Obamacare is already helping the clinic expand its primary-care services thanks to an early grant it received under the law.


(Melina Mara/The Washington Post) Obamacare supporters in April when the Supreme Court was hearing arguments on the Affordable Care Act.

"The Supreme Court—hopefully they're doing the right thing by making sure that insurance is available to all people, not just those can afford it," Dr. Veronica Jenkins, the clinic's medical director, said after she heard news of the ruling.

Benjamin Johnson, who was waiting outside a food bank in the lobby of the building, said he hoped that the decision wouldn't have a negative impact on Medicaid. (Under the ruling, states are now permitted to opt out of the program's expansion without losing all of their federal funding.) Before enrolling in Medicaid a little over a year ago, Johnson went to the ER instead and racked up $11,000 in medical bills. "My job doesn't give me health care. I'm 49 years old, with high blood pressure, sciatica," said Johnson, who earns $12,000 a year through his part-time job at a moving company. The difference now: "I pay a dollar for medication, and that's a blessing," Johnson said. "I work and pay taxes and still can't afford health insurance [on my own]."

The District of Columbia is actually one of the few states that's already moved ahead with the Medicaid expansion ahead of 2014. As such, Jenkins says she expects to her clinic to see more low-income patients with insurance. "That's more revenue to help keep the clinic alive," she explained. And having more insured patients means it will be easier to subsidize patients who are still uninsured and can't pay, Jenkins says. "It will increase the number of people who come to us."

But in the clinic's waiting room, where a video about a single mother was playing in the background, there was still some lingering skepticism. "I have mixed emotions," said Charles Griego, a sign-language interpreter who was accompanying a deaf patient. "It's a great idea that could benefit a lot of people," said Griego. But, he asked, "how is it going to be implemented?"

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Brad Plumer · June 28, 2012