The U.S. Senate passed its version of the health care reform bill in December. Three months later, the House of Representatives approved the proposal 219 to 212 vote. President Barack Obama signed the measure into law March 23. The reforms lined out in the bill will be phased in over a period of years.

Now clinics in the state are trying to figure out how the new law will impact them. Some health care experts expect as many as 32 million uninsured Americans eventually will have health insurance.

The West Virginia Association of Free Clinics, or WVAFC, operates throughout the state serving uninsured or underinsured West Virginians. The clinics historically have provided patients with primary care, preventative medicine programs, such as diabetes education and smoking cessation courses, lab testing, dental care and prenatal care.

Availability of coverage to more West Virginians has WVAFC Executive Director Jane West and clinic operators wondering what the free clinics’ role will be under the new health care system.

“Our primary focus has been and will continue to be providing quality patient care to those who cannot afford it, but where we will fit into the new system when changes take place is left to be determined,” West said. West said questions about the free clinics’ future roles have no clear-cut answers. She said a national conference for free clinic administrators scheduled for October may provide some answers.

“The biggest change will be the four-year transition period lawmakers have discussed to implement the changes,” West said.

West said the clinics’ immediate role is helping those who have not had coverage get into the new system. “We will definitely be there for our patients, educating them on the process and ensuring that if they can receive coverage, that we help them get into the loop,” West said.

Laura Jones, administrator of the Milan Puskar Health Right in Morgantown, agreed with West that free clinics will help with educating patients about new health care options and how to access those options.

“Access is not just about having an insurance card or medical card. It is about having information and being educated about options, so I believe we can be of service in that arena,” Jones said.

Jones said she believes the clinics still have a future in the state, although the role currently is not clear.

“There will still be those that fall through the cracks, that will need quality health care in this state,” Jones said. “We do not want people to believe the operation of free clinics need to cease.”

Both Jones and West predicted some changes for the clinics’ traditional roles because health care clinics will see an increased and immediate need for health care as more patients are insured.

“Where are these 30 million people going to access care from?” West asked. “It will be a huge undertaking.” Jones added that free clinics are the most fluid of health care options and will provide flexibility within the new health care system.

“Free clinics are adaptable because we are already in the mindset of doing more with less, and this gives us an opportunity to continue to fill a gap in the overall health care system,” Jones said.

Jones said state and federal lawmakers should give clinic administrators some direction.

“There are many rules and regulations that will be involved with this legislation, and once they are actually determined, we will be able to find a more clearly defined path as to what our future is,” Jones said.

West said the new health care system will come into existence gradually, and she sees a future for the free clinics throughout the state.

“We will be here in some capacity through the transition and beyond,” West said.