What About Obamacare?

“Now that we have Obamacare, do we still need places like Tapestry Health?” This is a common question I hear nowadays.

From its beginning Tapestry has fought for desperately needed access to care—first for women profoundly in need of family planning services, and then for the many marginalized and low-income communities we serve today. And over the years we have seen progress. 2006 marked a big victory for greater access when Massachusetts led the way toward universal coverage. More recently President Obama built the national Affordable Care Act based on the Massachusetts model, bringing health insurance within reach for millions.

So hasn’t the access gap been closed? Who is left for Tapestry to serve? If people have insurance, can’t they just go to their regular doctor? Why do they need us?

Questions like this were raised at this month’s National Family Planning and Reproductive Health Association’s regional meeting in Indiana, which I attended with Tapestry managers. We encouraged caregivers from other programs in other states, which are just getting used to the ACA, to look to Massachusetts to understand how their work will continue to be critically important. Because the reality is that, despite eight years of greater access, community-based healthcare is still a crucial element in our state’s safety net.

Consider who Tapestry serves. Of our 6,800 annual reproductive health patients, 95% report incomes at or near the poverty level. For these clients the challenges of daily life are staggering. The time, financial and logistical costs of a traditional doctor’s appointment are prohibitive. Social barriers rooted in language, culture and the need for trauma-informed care can also be impediments. Moreover, while many have been insured for years under Mass Health, Western MA residents struggle even to find doctors in the face of a provider shortage that the Springfield Republican deems a “medical emergency.” 

Tapestry Health is vital in filling these gaps. With same or next-day appointments, the ability to accept walk-ins, sliding-scale services, and offices throughout the area, Tapestry provides trauma-informed, culturally-sensitive care locally and immediately.  

So, do we still need places like Tapestry? Yes. Even with Obamacare, Tapestry’s work remains essential to the health of our region. A better question is, “How can Tapestry 2.0 leverage new access to coverage to serve our community in a more comprehensive way?”  It is this question that we will strive to answer in the months ahead.