People aren’t going to disappear, so where do they go?

A two-minute walk down the road from Planned Parenthood’s Seaside Health Center sits the Seaside Family Health Center on Fremont Boulevard. Unlike Planned Parenthood, there aren’t protesters out front, but there are people waiting in a line that snakes out the door and onto the narrow walkway, despite the fact that the clinic is supposed to close in 45 minutes, at 5pm.

Like Planned Parenthood, the Monterey County Health Department operates safety-net clinics, which provide health care services to those in need regardless of their ability to pay. There are a total of 25 safety-net clinics in Monterey County, including nonprofit Clinca de Salud del Valle and Natividad Medical Center. Like Planned Parenthood, most of their funding comes from MediCal reimbursements.

The last time there was a sudden high influx of patients for Monterey County Health Department clinics was back in 2014, when Monterey county enrolled about 180,000 more people under the ACA. Edgcomb says their clinics absorbed about 10,000 more patients at the time and the immediate effects were a shock to their system.

But because the ACA expanded Medicaid, the health department received more federal support and adjusted to need. Currently, in order to serve their 50,000 patients through their nine clinics, they operate on a budget of $48 million, compared to $96 million for 36 Planned Parenthood clinics. They hired more doctors and staff, expanded their facilities and even added a new pediatrics center (50 percent of their patients are under the age of 18). They’re also bulking up the Seaside Family Health Center; its brand new addition is set to open no later than June, 2018 and totals 20,000 square feet, with 33 exam rooms and a dental suite. The expansion could enhance the clinic’s ability to conduct walk-in immunization, preventative and primary care, adult and well-child exams, chronic adult illness management, family planning including STD screening/treatment, obstetrics care, comprehensive perinatal services program (CPSP), latent tuberculosis treatment (LTBI) and adult and child psychiatry.

Edgcomb knows there are still long waits, but they’re getting shorter, and more people are getting access to health care. “It’s not perfect,” says Edgcomb, “but we’re working to make sure we’re taking care of every resident that needs us.”

Planned Parenthood patient displacement has affected the health department before. Mar Monte once operated three clinics in Monterey County, but had to shut down their Greenfield location in 2013.

Those patients suddenly faced a minimum one-hour commute round trip to the nearest Planned Parenthood in Salinas.

Edgcomb cuts to the bottom line. “Take away their insurance and there’s people waiting until they get very sick,” says Edgcomb. “What you’re creating is a healthcare system that’s constantly treating diseases instead of preventing them.”