TAMPA - When Sharon Brown lost her job in a factory, she didn't know how she would afford her cholesterol medications.
Brown needed Tricore and Lipitor, but without health insurance, the cost was too much for her budget. The 62-year-old said she also has chronic back pain, which often keeps her in bed.
"I can't do nothing, Brown said. "I can't work anymore. I can't clean the house. Just standing up to fix toast, my back went out."
Brown's situation is similar to that of many Floridians. About 3.6 million statewide are uninsured, according to the Census Bureau. In the Bay area, about 20 percent of residents do not have insurance, but they are not without options.
Florida has 16 free clinics affiliated with the National Association of Free Clinics, in addition to non-affiliated free clinics.
Many of the clinics' patients are uncertain what the recently adopted changes in health care policy in the United States will mean for them. But they are thankful for the care they receive at the clinics.
One of those has taken some of the stress out of Brown's life.
Two years ago, her roommate suggested she go to the Community Aging & Retirement Services Clinic.
The CARES clinic in Pasco County provides low-income and the uninsured who are 55 and older with primary medical care. Volunteer nurses and doctors treat about 331 patients annually. It is supported in part by grants and funding from private foundations, as well as donations.
"I'm better off at the CARES clinic. If it wasn't for them, I wouldn't be able to have my cholesterol in check," Brown said.
Free and sliding-scale fee clinics, such as CARES, are an alternative for those who cannot afford insurance or paying out of pocket at a regular doctor's office or at an emergency room.
Brown is a few years away from receiving Medicare, and she isn't sure how the health care reform law will affect her.
"It doesn't tell me a whole lot. Yeah, sure, it says we're going to get insurance, but who's going to pay for that?" Brown said.
Jay Wolfson, a professor at the University of South Florida's colleges of Public Health and Medicine, said the nation will feel the financial effects of the reform law within two years.
"The implementation of these reforms are going to involve reductions in payments to hospitals, physicians and other providers - and these could have effects on access to care," Wolfson said.
"At the same time, there are other elements of the reform package, relating to prevention, public health, fraud and abuse that can begin to make a difference in cost, quality and access."
Shane Dellinger and his partner, Ivan Flow, have been going to the St. Petersburg Free Clinic for two months. Both are diabetic and rely on the clinic for medications.
Flow's insurance covered him and Dellinger, but he said he lost his insurance because of the economy and couldn't afford new coverage.
"I always had health insurance and I never realized what they did until we needed them," Flow said.
After going two years without insurance and medications, Dellinger, 50, and Flow, 52, went to the St. Petersburg Free Clinic.
"When we came in, we both had blood sugar that was severely above stroke level. I think the clinic saved our lives," Dellinger said.
The St. Petersburg Free Clinic was founded in 1970. Forty-one doctors and 37 nurses oversee about 6,500 patient visits per year.
Ronda Russick, director of the clinic's health center, said the main goal is to provide basic medical care to the uninsured.
"We help those who fell between the cracks and who don't qualify for health care elsewhere," Russick said.
About a quarter of the clinic's patients were unemployed last year, a number that has declined recently, Russick said.
"We ask patients every month, where they would be if it weren't for the free clinic and the greatest percentage say 'I don't know' because there really is no other alternative," Russick said.
"The people (at the clinic) are volunteers, so they're here because they want to be here. It's their passion, not their paycheck," Dellinger said.
Flow said his treatment at the clinic surpasses his coverage when he had insurance, and he is skeptical that changes in the nation's health care will help him and his partner.
"I think the plan got watered down so much that I don't know," Flow said. "It's not going to kick in for four years and if it weren't for the clinic, I don't think we'd be around to see it."
Russick said there will always be a need for free clinics, even during the launch of the new health care program.
"It should make an impact on the uninsured, but it doesn't appear that it's going to address all the needs of the uninsured," Russick said. "I think there will always be those who don't qualify for a program. There will always be people falling through the cracks and that's who we're here to help."
Wolfson said he sees a need for free clinics even after the last phase of the reform law in 2014.
"Not all persons will be covered, and there will be periods of time during which some people may temporarily lose coverage and require safety-net services," he said.
Young and invincible
Andres Felipe Garzon said he rarely gets sick. If he does, prayer is the 25-year-old's preferred treatment.
"If I get sick, I pray. I stay home," he said. "I will go to the emergency room if it's something that has been bothering me for days."
Garzon's age and views on insurance make him one of the "young invincibles" - young adults who do not think they need health insurance.
Adults ages 19 to 29 make up 30 percent of the uninsured in the United States - the highest rate of any age group nationwide, according to the Kaiser Family Foundation.
For Garzon, a Colombian who moved to the United States eight years ago, the cost was a deterrent.
"The cost compared to what I'm really going to get for it won't be worth my coverage," he said.
Garzon said he hopes the health care reform will help him get medical care without having to go to the hospital. He is still making payments on a $3,500 bill for an emergency room visit one year ago.
"Maybe I can be seen regularly by a doctor," he said. "If the consequence is that the government goes into debt ...well they get into debt for things that are less important. I see people as the priority," he said.
An unusual 401k
Nestled in the Islamic Society of Tampa Bay is a nondescript portable where Roh Afridi has spent most of her Thursdays since 2001.
Afridi is a family care physician who volunteers at the Red Crescent Clinic of Tampa Bay.
Since opening in 2000, the clinic sees 400 to 500 uninsured patients per month.
"Anybody can come here, regardless or race, religion, craft or creed," Afridi said.
The Red Crescent Clinic provides routine physical exams for adults and children, EKGs and internal medicine care, as well as visits with urology, endocrinology and cardiology specialists.
The clinic's aim is to give quality care to everyone, with an emphasis on preventative medicine, especially when it comes to diabetes.
According to healthreform.gov, 10 percent of Floridians have diabetes-a figure Afridi said is evident at the clinic.
"A lot of patients here have diabetes. Even if they don't, I tell them to eat as if they are a diabetic," she said. "If they continue eating the way they do, they will develop it. Preventative medicine is the key to success."
She expects there will continue to be a need for the Tampa clinic even after the new program is in place.
"I'm hoping that everybody will have insurance with the new law," Afridi said. "And that you wouldn't need a clinic like ours. But I think the community still will need it. A lot of times, our patients are visitors who can't afford to pay $100 to a walk-in clinic and then get a prescription for another several dollars."
Dr. Maqsood Siddique, a cardiologist, is the clinic's medical director. He said there is a fear that comes along with change in health policy, especially in the medical community.
"As physicians, we always feel scared that somebody will take something from us and give to someone else," Siddique said. "But, step back and look at the whole picture. It looks like the health bill will help all of us in general, especially when I see patients. It is heartbreaking. They have nothing, and I have everything. This is not right."
The clinic runs much like any other doctor's office, but relies solely on donations and volunteers, Afridi said.
There is still a need for funding, Siddique said. Money for advanced testing is the clinic's biggest need. But the community has enough volunteers who work hard to keep the clinic running.
Dedication and a desire to help keeps Afridi coming to the clinic every week.
"I consider this my 401(k) for the hereafter," she said.
Carmel Delshad is a recent graduate of the University of South Florida. She was a multimedia journalism student. Students Marja Martinez-Ortiz, Jillian Fredenhagen and Shana Johnson contributed to this report.