Editor's note: Alan asked that his full name not be used out of sensitivity to his wife and her prior medical condition. For this reason, he is being identified by his middle name.
Alan never expected to be waiting for medical advice in the back corner of a northwest Gainesville church in January, whispering his wife’s medical history to a student volunteer behind a makeshift privacy screen that did nothing to prevent being overheard. He recalled telling the volunteer his wife's story and being told to take a seat.
“And then we went and sat in the back of the church,” Alan said, “very far away from earshot of other people.”
The 42-year-old, recently wed Navy veteran and University of Florida graduate student had health insurance through the federal Veterans Benefits Administration. But his wife of less than a year was uninsured — and pregnant. And she was experiencing an emergency — a miscarriage.
Affordable healthcare hard to find
Even before the Oct. 1 federal government shutdown put the spotlight on Congress and its internal fight over extending tax credits for people insured through Affordable Care Act (ACA), it had become increasingly difficult for Floridians to find affordable healthcare. More than 4.6 million Floridians signed up for the ACA last year. The Sunshine State now has the highest ACA enrollment rate of any state.
Without an extension of tax credits that are set to expire at the end of this year, Floridians could be looking at skyrocketing premiums. Some experts project these premiums would increase by more than 150%.
An estimated 10.9% of Florida’s 24 million residents lack healthcare coverage. This is almost 3 percentage points higher than the national figures — only 8.2% of the U.S.’s 347 million citizens do not have healthcare.
This makes it highly likely that more people will seek healthcare through clinics like where Alan and his wife went.
In Alachua County, a little less than 6% — about 17,000 — of its approximately 289,000 residents are uninsured, according to 2024 data from the Census Bureau's American Community Survey (ACS).
Waiting for an emergency
While there are affordable clinics for health and dental care located throughout Alachua County, knowing how to access them could be a challenge. However, there are some people who wait until it’s an emergency to find out where they can get healthcare help.
“I think a lot of people just in general don’t want to see the dentist unless they’re in pain,” said Humna Ahmed, a dental-assistant volunteer at the ACORN Clinic. “Like, it’s only necessary if absolutely necessary. I think the idea of going routinely and getting a cleaning isn’t really something they really think about.”
The uninsured in Alachua County have options such as the ACORN Clinic, a nonprofit organization providing dental care in North Central Florida. It is a full-service dental office, offering preventative, maintenance and emergency care.
ACORN offers comprehensive dental care on a sliding-scale fee that is based on a patient’s income and family size.
“I think dental care is very important,” Ahmed said. “If you have a really big problem in your mouth, it’s probably affected the rest of your body. And dental pain is no joke.”
For providers, one of the first steps in creating a treatment plan is educating the patient. People seeking emergency care for the first time may not know of all the options or the healthcare they already qualify for, said Lauren Faison-Clark, the CEO of Doctors’ Memorial Hospital in Perry, Florida.
That brings us back to Alan and his wife, the expecting couple seeking medical help. Their original plan when they first found out she was pregnant had been to allow the pregnancy to progress and wait until the 30-day enrollment period began in May to sign her up for a UF health insurance plan. In the meantime, they would pay out of pocket for their first appointments.
But those plans were scuttled. She suffered a missed miscarriage, which is when a fetus stops developing and must be removed from the uterus to prevent further complications for the mother.
Suddenly, finding the proper care became a lot more complicated.
“We couldn’t not deal with it,” Alan said. “She was hurting, and I was just trying to find a path to relief.”
Alan was not sure where to find medical resources for his wife, so he turned to the social media platform Reddit. Someone directed him to the Equal Access Clinic Network (EACN), a network of free, student-run health clinics.
Alan’s wife, a native of Colombia, felt more comfortable discussing her situation with a Spanish speaker. So, the couple attended a Spanish-language clinic run on Monday nights at the Spanish Seventh Day Adventist Church in Alachua County.
Unlike other primary-care facilities, the EACN does not have the resources to ensure that every patient has a private room. At the church, the nave acts as a waiting room, with the altar being the designated space for vitals and check-ins.
“If you’re sitting within the first three or four rows of that church,” Alan said, “you can definitely hear as they (other patients) share.”
Despite the lack of privacy, providers can build trust with patients by trying to get a sense of what they need and explaining the reasons for the recommended treatments or medications, said Cecelia Miller, the EACN student medical director for the Monday night clinics.
But as it turned out, Alan’s wife needed specialized healthcare that the clinic could not provide.
“At our clinic site, we don't have any OBGYN-specific providers, and most of the doctors we have at our site are either trained in primary care, or they're highly sub-specialized and do this out of the goodness of their hearts,” Miller said. “An ICU physician has no idea how to handle an OB concern.”
Alan then decided to take his wife to St. Augustine to be seen at a clinic where he had volunteered in the past. He scheduled an appointment with a volunteer obstetrician at Wildflower Healthcare, a community clinic. His wife was prescribed medication to relieve pain. She was also seen at two follow-up appointments and made a full recovery.
While a clinic may not be able to serve every need, clinic networks can help to relieve the load on emergency rooms, leading to less crowded emergency rooms and shorter wait times and benefitting people with and without insurance, according to the National Library of Medicine.
Alan and his wife ultimately enrolled in a UF health insurance plan and both are now insured. But for those not affiliated with the university, the struggle for accessible healthcare continues.
With or without free healthcare, it is important to be prepared for emergency medical conditions.
“For others in need of such healthcare, I simply caution them if the medical attention is somewhat complex, it will take time to talk to people and find a path to meet your medical needs,” Alan said. “Common issues have common answers, but a means of treating unusual ailments will often take some time and research to find.”