At the Oasis Free Clinic in Brunswick, the rapport between nurse practitioner Bronwyn Sewell and patient Alex Vale is evident. They laugh even as Vale, who uses the pronouns they/them, describes pain they’re experiencing.
Vale has been coming to Oasis since last summer. Before that, they were living in Florida, and had health insurance.
“I lived a relatively normal, I think what you would consider to be standard lifestyle at the time,” Vale said. “I had a job and a car and a partner and an apartment.”
Then, Vale’s dad got sick. They became his caretaker, and within the span of a year, Vale says they lost it all: their dad, their job, their partner, home, car, and insurance.
“So this has been a dramatic, like, falling off a cliff,” they said.
Vale moved back home to Maine, feeling physically sick and also needing mental health support. Despite not having insurance, they were able to get that care at Oasis. The clinic provides free primary, dental, and optometry care, and up to 12 weeks of counseling. And because it doesn’t accept insurance, it can offer longer appointment times, which Vale said has made a huge difference.
“I was working hard leading up to the point where I decided to take care of my dad, and this stuff could happen to anybody,” Vale said. “And like, this place here, was able to recognize like, here’s a person who wants to get well and had the resources to actually like, just put a base underneath me.”
“It takes a lot for a patient to call us, to need help,” said Oasis nurse practitioner Michelle Barber. “We often have patients say, I never thought I’d need a free clinic.”
Barber said Oasis is getting those calls more often. Some patients are asylum seekers, others are traditional Mainers.
“People who are underemployed, working either as lobster fishermen, or self employed doing odd jobs, or working at a gas station,” she said. “They are people who make enough to survive.”
But earn too much to qualify for MaineCare and not enough to afford health insurance. To meet the need, Executive Director Anita Ruff said Oasis is expanding into a larger space in Brunswick this summer, with the help of federal funding.
“And so our hope is that by adding more space that we’ll see at least 25% more patients in the medical clinic,” Ruff said. “Our hope is to add 50% more patients in the dental clinic and really begin to serve more of the need in the community than we do right now.”
Oasis is among a handful of clinics in Maine that offer free care. Two others in Rockland and Ellsworth said they’re also seeing high demand. It comes at a time when there are more options for coverage. The state expanded MaineCare in 2019, and the Affordable Care Act’s online marketplace has offered subsidized health insurance plans for a decade.
“I wouldn’t say we’re losing ground,” said Ann Woloson, Executive Director of Consumers for Affordable Health Care. “I’d say we have more to do.”
Woloson said health care costs are rising and need to be addressed. But she also suspects that some people are missing out on affordable plans because choosing insurance can be confusing.
“And are maybe sticker shocked by what they first see but don’t understand how much subsidy might be available to them and that they have limited cost sharing. Like, very low deductibles, if any,” she said.
But Anita Ruff at Oasis said there’s another factor beyond insurance that’s driving up demand for their services: a lack of primary care providers. She said when an Oasis patient qualifies for MaineCare, the clinic used to transition them to providers in the community. But Ruff said they’ve stopped doing that.
“Because right now there’s nowhere for them to transition to in the community,” she said.
Taryn Walker, who has auto-immune issues, is one of those patients. “Every single place that I called, they said they’re not taking new patients under MaineCare,” Walker said. “Every single place.”
Walker said as she tried unsuccessfully to find a doctor, she started to panic.
“Does this mean I’m not going to have care again?” she said she thought. “Oh no. I’m not going to be able to go to Oasis anymore and I can’t find any place that will take me, so therefore I’m back to not having any care.”
Walker was relieved when Oasis told her she could continue to go to the clinic for primary care.
“I’m just so grateful for the care,” she said. “If I had great insurance, I would still want to go there for the care that I get.”
Walker said she’s had all kinds of insurance – including employer-based and marketplace plans. But the care she’s received at Oasis has been the best.