As health costs climb, some care shifts to Michigan’s charity clinics

Michigan’s free health clinics are facing an increase in demand as insurance costs increase
It marks a dramatic shift in health care — from government- and employer-subsidized care to charity care
Leaders say they expect the hardest hit in January, when Medicaid rules change. ‘We’re ready,’ says one

WEST BRANCH — Christine Cunningham sat stock still on a hard-backed chair of a clinic waiting room last week — another datapoint in the state’s growing affordability crisis.

When insurance premiums topped $600 two years ago, she said, “we dropped it. It was essentially half his paycheck.”

So each day, 58-year-old Cunningham takes vitamins and tries to avoid stress, despite the relentless pressure on her chest these days and the unknown results of a hospital scan on her heart.

“You go to work everyday and try not to think about it,” she said.

As health costs increase and health coverage drifts out of reach, Cunningham and Michiganders like her soon may turn to places like Ogemaw Hills Free Clinic, one of a network of little-known clinics around the state.

Unlike the network of federally qualified health centers, free clinics charge patients “nothing, not a penny,” said Laura Schorn, office manager of the Ogemaw Hills clinic, located in a blue-domed, converted church school off I-75.

Here, the numbers of patients in the first eight months of the year jumped from 149 two years ago to 229 patients in 2026.

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Yet Ogemaw Hills and other free clinics, which last year served more than 33,000 Michiganders, largely operate on shoestring budgets and good will.

Doctors, nurses and pharmacists are volunteers.

Drugs are donated by manufacturers. Lab tests are the charity work of local hospitals.

Fundraising is a full-time job for clinic leader Ann Heler, who was the long-time director of the Free Clinics of Michigan and now serves on the organization’s board.

Free clinics are often limited in both the hours they operate and the specialists they provide.

Still, they can be lifesaving for those who have nowhere else to turn, pressuring clinic leaders to be constant fundraisers, too.

“You’re just on the hustle all the time,” Heler said.

A male doctor uses a stethoscope on a male patient seated on n exam table — Dr. Larry Gaetano volunteers his time at St. Peter’s Free Clinic of Hillsdale, which shares space inside St. Peter’s Episcopal Church in this southeast Michigan community. (Robin Erb/Bridge Michigan)

That pressure is likely to increase with upcoming cutbacks in Medicaid.

Most immediately, full Medicaid benefits end for many non-citizens, including those who are lawfully present in the US, on Oct. 1.

The biggest change, however, will be Jan. 1, when new federal Medicaid rules will require some 650,000 Michiganders to document twice a year that they are working or volunteering 80 hours a month or have some medical or other exemption from those work rules.

Already, Michigan’s expanded Medicaid — known as the Healthy Michigan Plan — has been shrinking, likely for a number of reasons.

By last month, according to state data, it had dropped to its smallest enrollment since the administration of then-Gov. Rick Snyder, who served from 2011 to 2019 .

Meanwhile, mid-year data suggested that 130,000 fewer Michiganders were insured through the federal Affordable Care Act marketplace earlier this year, compared to the previous year, as costs shot up about 20%.

Among patients at FernCare Free Clinic, “over 80% of them have a job. Many of them have two,” said executive director Dan Martin.

They are, he and other leaders said, the “working poor” when it comes to health care — Michiganders with stable lives and conventional jobs, but stuck with incomes that are too high for Medicaid and too low to afford insurance elsewhere.

But while coverage shrinks, health care needs do not.

“A lot of calls we’re getting now are people losing their Medicaid because their income has gone up,” said Schorn, the office manager at Ogemaw Hills. “Then I expect more come January, when people can no longer pay the premiums on the Affordable Care Act (marketplace).”

A shift from predictable to good will

Cunningham, who was waiting for her appointment recently, said she walked away from the hospital not so long ago, where a doctor had wanted to run more tests when her chest felt squeezed, her head ached, and she went dizzy.

Her blood pressure bottomed out. A doctor there wanted to run more tests, but her job pays less than $14 an hour, she said.

“I told him no, I can’t afford it. I don’t know who’s going to pay this bill now,” said Cunningham.

Cunningham, who has been trying to stop smoking, hopes for the best, steeling herself for a day when she might need emergency care.

“You just try to get through it, and you go to work, you do your job, and you’re glad when you can relax,” she said.

stacked photo collage of a cart filled with pill bottles in a clinic on top and a pile of walkers at the bottom — Ogemaw Hills Free Clinic in West Branch and others rely on donated medicines and supplies, charging patients nothing for care.
(Robin Erb/Bridge Michigan)

Clinic staff work with patients like Cunningham to find free follow-up elsewhere when necessary — biopsies and blood tests, medications and appointments with specialists, said Lynn Burkett, executive director at St. Peter’s Free Clinic of Hillsdale.

There, at the clinic tucked into the back of St. Peters Episcopal Church, some St. Peter’s staff recalled lines of patients, dozens deep, each Tuesday night the clinic was opened before 2014.

That’s the year Michigan’s Medicaid expanded to working-age, otherwise healthy adults under Obamacare and government-subsidized policies made coverage more affordable to the federal marketplace.

The patients dwindled over time under that expanded coverage — to about a half dozen patients now each week.

Burkett, too, expects those numbers will change in the coming months if more Michiganders lose insurance.

Even her own insurance, at more than $700 a month, is a “don’t-get-sick” policy with a high-deductible, she said.

Mary Lewis, CEO of Michigan’s largest free clinic, the Gary Burnstein Community Health Clinic in Pontiac, sees an opportunity in the changes ahead.

The clinic provided 9,518 patient visits last year; it’s on track to provide 12,849 visits by the end of the year — a 34% increase, she said.

As more people seek care at free clinics, they will avoid the more expensive care at emergency rooms, where costs are covered by health systems, taxpayers and even insurers — ultimately driving up costs for everyone, she said.

When all goes well, free clinics stabilize health conditions and lives, ultimately allowing patients to return to work and obtain better insurance.

“Even if from an emotional perspective, if you don’t believe everyone should have care, it’s a good business model,” she said.

She and Heler, who also helped found FernCare in Ferndale, say they worry less about fundraising and recruitment than they do patients who might otherwise go without care as they lose insurance in the coming months.

People want to help others in need, especially when it comes to essential health care, and they remain confident that incoming pressures will make clinics stronger.

“We’re ready,” said Heler. “We will be here.”

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