Insuring the uninsured: A student-run initiative to improve access to care in an urban community

J Natl Med Assoc. 2006 Jun;98(6):906-11.


Context: There are 44 million uninsured Americans. Lack of insurance creates a major barrier for the poor and near poor to get adequate medical attention. A portion of these are eligible for insurance and either do not know they are eligible or have difficulty navigating the application process.

Objective: To evaluate the success of University at Buffalo medical students at a free clinic in helping patients enroll in government-sponsored insurance plans.

Design: Observational study

Setting: The Lighthouse Free Medical Clinic--a student-run free clinic operating in an urban minority Buffalo, NY neighborhood.

Patients: Five-hundred-seventy-nine inner-city, low-socioeconomic-status patients age <65.

Intervention: All patients are screened, and those eligible are encouraged and assisted in completing insurance applications.

Outcome measures: Primary outcome is the percentage of patients who completed the application process.

Results: Five-hundred-seventy-nine patients were seen from October 2003 through October 2004; 319 (55%) were uninsured. Fifty-nine (26%) of those uninsured were found to be eligible for insurance. Fifty-seven applications were initiated, and 23 (40%) were completed and accepted.

Conclusions: There are a significant number of people using the free clinic who are eligible for insurance. The number-one reason adults were ineligible was household income exceeding the state limit. Success of this project provides support for the use of medical student volunteers to assist in insurance application completion in community settings.

Publication types

  • Evaluation Study

MeSH terms

  • Adult
  • Black or African American / education
  • Community-Institutional Relations*
  • Eligibility Determination*
  • Forms and Records Control*
  • Health Services Accessibility*
  • Humans
  • Medical Assistance / organization & administration
  • Medical Assistance / statistics & numerical data*
  • Medically Uninsured
  • Middle Aged
  • New York
  • Poverty / ethnology
  • Program Development*
  • Program Evaluation
  • Schools, Medical
  • Social Class
  • Students, Medical*
  • Urban Health Services / organization & administration*