When Coverage Shrinks, Volunteers Step In. We Are Stepping In – with Them.

As millions risk losing subsidized insurance, free clinics and their volunteers will carry more of the load. NurseMagic™ is choosing to stand beside them.

The Patient Protection and Affordable Care Act (ACA), signed March 23, 2010, introduced Medicaid expansion and income-based premium tax credits for Marketplace coverage beginning in 2014¹. From about 2010 to 2023, the uninsured rate for people ages 0–64 fell from roughly 17–18% (about 46–48 million people) to about 9.5% (about 25–26 million), according to Census-based estimates². In 2023, total federal health subsidies and health spending were about 1.6 trillion dollars, of which roughly 91 billion dollars (about 6%) were ACA Marketplace subsidies, a share projected to decline modestly as overall federal health spending grows as a share of GDP³. Nonpartisan analyses attribute most coverage gains to Medicaid expansion and Marketplace subsidies, while overall U.S. health-care spending and premiums have continued to grow faster than general inflation for multiple reasons. As of January 2026, the temporary “enhanced” ACA premium tax credits that were in effect through the end of 2025 have expired, and early projections indicate that, under current law, average premium payments for many subsidized Marketplace enrollees in 2026 will rise on the order of roughly 75–100%, with several million people expected to leave or forgo individual-market coverage unless new policies are adopted⁴.

Free and charitable clinics number around 1,400 nationally and provide care to roughly 2 million patients and about 6 million visits annually, 84% of which are for uninsured people⁵. Modeling of the subsidy expiration indicates about 4.8-5 million additional uninsured people in 2026⁶. If 25-40% of these newly uninsured (roughly 1.2-2.0 million people) seek care at community health centers or free clinics, this implies about a 2-4% volume increase at health centers (on a ~52-million-patient base)⁷ and roughly a 20–50% increase in demand for free clinics (on a ~2-million-patient base), shifting a measurable amount of care from subsidized insurance into settings that depend heavily on grants, donations, and volunteer clinicians.

Free and charitable clinics depend on a large but finite volunteer workforce. They report roughly 190,000 volunteers, including about 76,000 clinical volunteers (physicians, advanced practice clinicians, dentists, mental health providers, nurses, pharmacists, and students) and about 114,000 non-clinical volunteers. Nearly all such clinics use licensed volunteer clinicians for direct care, with heavy participation from practicing and retired professionals and health-profession students. Studies find volunteers are motivated by commitment to underserved patients, professional growth, and personal values, but also face time pressure, emotional load, and burnout risk, indicating that any surge in uninsured patients would add stress to a workforce whose capacity is limited by available volunteer hours and basic operating resources.

As free clinics absorb care once paid for by public dollars, our Team at NurseMagic™ is committed to contributing alongside these organizations in the form of time, tools, and genuine partnership, at no cost to them. We know that the people closest to the bedside are carrying more than they should have to, and free clinic teams are at the very center of that reality. In the coming years, as more patients lose subsidized coverage and turn to safety net care, the burden will not fall on systems alone; it will fall on individual nurses, clinicians, and volunteers trying to do the right thing with limited time, resources, and backup.

NurseMagic™ is providing three months of full, no-cost access to the app for anyone who volunteers at a free or charitable clinic. This applies whether you are a nurse, other licensed clinician, student, or non-clinical volunteer, as long as you are actively contributing your time to a free-clinic setting. The goal is simple: if you are giving your labor to care for uninsured and underinsured patients, we want NurseMagic™ to help shoulder your documentation, information-gathering, and communication workload during that time.

We hope NurseMagic™ lightens the load for free-clinic professionals in real, practical ways – minutes saved on notes, fewer clicks to find an answer, a little more energy left at the end of a shift. Everyone involved in building NurseMagic™ has benefited from education, training, and care that made our own work possible, and we see this as a way to honor that debt while we continue our commercial mission.

When the system leans harder on volunteers, we want them to feel less alone. And back up the people who show up, so they can keep showing up for everyone else.

If you or someone you know is interested in our free program for free clinics, please reach out to hello@nursemagic.ai

Sources:

1. https://www.hhs.gov/healthcare/about-the-aca/index.html

2. https://www.kff.org/uninsured/health-policy-101-the-uninsured-population-and-health-coverage/?entry=table-of-contents-trends-in-the-uninsured-rate

3. https://www.pgpf.org/article/how-does-the-federal-government-subsidize-healthcare-under-the-aca-and-what-does-it-cost/

4. https://www.kff.org/affordable-care-act/8-things-to-watch-for-the-2026-aca-open-enrollment-period/

5. https://nafcclinics.org/wp-content/uploads/2025/06/NAFC-FACT-SHEET-2025-1_compressed.pdf

6. https://www.urban.org/sites/default/files/2025-09/4.8-Million-People-Will-Lose-Coverage-in-2026-If-Enhanced-Premium-Tax-Credits-Expire.pdf

7. https://www.nachc.org/resource/americas-health-centers-by-the-numbers/