Though millions of Americans are poised to get help next year to pay for health care coverage, thousands are likely to slip through the cracks, including many in South Carolina, according to the new executive director of Hilton Head Island Volunteers in Medicine.
Dr. Raymond Cox, who began his new job Monday, says VIM's clientele of uninsured and under-insured people is likely to grow even after major elements of the federal Affordable Care Act are implemented.
"I see a continuing role for Volunteers in Medicine ... primarily because the (insufficient) number of physicians and providers needed to take care of all of the newly insured," Cox said. "... (And) I think there will be a tremendous need for these clinics because of (coverage) gaps that are created under the law."
In some states, those who qualify for expanded Medicaid will not have to pay premiums. But in others -- including in South Carolina -- they will.
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The Supreme Court has ruled that Medicaid expansion is optional for states; South Carolina has opted not to expand that coverage.
About two-thirds of VIM patients would have received coverage under the expansion, said Lisa Drakeman, chairwoman of the clinic's board of directors.
"There are people who will still need our care," she said. "And even after they receive subsidies to buy insurance, they would still have a pretty substantial payment for their insurance premiums and out-of-pocket costs they'd be responsible for."
Health care experts are bracing for a jump in insurance rates next year as many of the law's major reforms are enacted, including a regulation requiring insurers to cover individuals no matter how sick they are.
Cox was hired after a national search by the VIM board to succeed Dr. Frank Bowen, who retired at the end of last year after 12 years as medical director of Volunteers in Medicine.
Under Bowen's tenure, the clinic grew from six exam rooms handling 17,000 to 18,000 patient visits a year to 14 exam rooms and more than 33,000 patients visits a year, according to VIM.
The clinic -- celebrating 20 years -- provides medical, dental and mental-health services to low-income people who live or work on Hilton Head or Daufuskie islands and cannot afford care on their own.
Since July 2011, Cox had served as senior vice president of medical affairs and chief medical officer of Providence Hospital in Washington, D.C. Previously, he served at St. Agnes Hospital in Baltimore as the chairman of the Department of Obstetrics and Gynecology. He recently was appointed to an advisory committee on infant mortality by U.S. Department of Health and Human Services Secretary Kathleen Sebelius.
Cox and his wife, Marilyn, own a home on Hilton Head and have vacationed there for more than 30 years.
"We are so fortunate because Dr. Cox has been dedicated his entire career toward caring for and improving the health of medically under-served women and their families," Drakeman said. "He has the ideal background to understand our patients."
The (Charleston) Post and Courier contributed to this report.
Follow reporter Tom Barton at twitter.com/IPBG_Tom.