- [Narrator] February, 2020.

It's just before the Corona virus hit Washington State and the Seattle King County clinic is in full swing at the Seattle center.

The annual four day clinic has been taking place since 2014.

It's a volunteer driven event that offers free health care to thousands of Washingtonians who might otherwise not be able to afford it.

And it's very in demand.

- [Yuphoi] We've seen close to a thousand people per day.

- [Narrator] Yuphoi is a recently retired general surgeon.

Like many other volunteers at the clinic, he's frustrated by what he sees as a broken healthcare system.

- I think healthcare is a human right.

I don't think it's fair to have a double standard.

Some group of people can get anything they want and other people, if they can get in line, have to wait in line and then have to suffer the economic ravages of having finally achieved access into the system.

I mean, so there's many levels and barriers.

- [Narrator] Barriers to care, take many forms.

Rural areas often face a shortage of nearby medical providers or facilities.

Patients who speak limited English, may deal with inadequate language services.

But the main barrier to healthcare for many Americans starts with simply being able to afford it.

- People have to have the financial means to access care in order to get reasonable quality of care, medications, procedures and things they might need for their health.

And so having insurance is hugely important.

- [Narrator] A peek at the clinic's numbers gives an idea of who is getting left behind.

Just over half of attendees surveyed, said they had no insurance.

Others had Medicaid, Medicare, or another form of coverage.

The most common cause for missing care, other than not being insured, was not being able to afford the cost even after insurance.

Others said their insurance didn't cover the services they needed.

- And so people don't seek care when they need it because they're afraid of how much it's gonna cost them.

Or they don't have health insurance to cover those expenses.

- [Man] It delays (inaudible) care, so people are arriving at the hospital much sicker, much later, and therefore much harder to treat.

- [Narrator] The people being affected most are a low income people of color, and many immigrants.

King County where the clinic takes place, has a population that's majority white.

Yet only 20% of Seattle King County Clinic patients this past year were white.

The majority were Hispanic or Latino.

Three times their share in the general population.

Black and African-American patients were also overrepresented.

The good news, health insurance coverage has improved in the last decade.

- [Woman] Since the affordable care act, we've seen the number of people, the percentage of people that don't have health insurance go down dramatically starting in 2018 and I think there's some signs in 2019 as well that that number is starting to creep back up.

- [Narrator] One suspected cause, is the Trump administration's public charge rule.

Which created a lot of fear among immigrant communities.

- It's time to begin moving toward a merit based immigration system.

- [Man] The new policy would for the first time weigh the use of benefits, like Medicaid, food stamps, and housing vouchers negatively.

When deciding whether to grant U.S permanent residency or citizenship.

- Over the past few years, the immigration laws have become incredibly complex.

This is having an impact for what patients and communities have access to.

And we have found that many individuals are actually turning away from care that they should receive, for fear that will make them ineligible for either citizenship or even green card.

That is not a good thing.

That is incredibly sad.

- [Narrator] The Biden administration plans to rescind the public charge rule, but it may take time to undo the damage done to immigrant communities.

Even then, making sure folks have health insurance is only part of the challenge.

Some who have access to healthcare, often find it too cost prohibitive to sign up or use it after enrolling.

- And the people that really get hit the worst are not the most destitute who have nothing to lose.

Those people are on Medicaid or they're getting social security.

And it's not the people who have the good jobs that come with a healthcare benefit.

It's the people that fall in the metal.

I have relatives who have small businesses and they really cannot afford care for themselves, their family or their handful of employees.

So we need a comprehensive coverage, for people, universal access and coverage.

Like the rest of the developed world does.

- [Narrator] In the meantime, community organizations are stepping up to meet the need as best they can.

Local health boards put on clinics and health fairs while hospitals like Harborview, offer charity care to patients who can't afford medically necessary treatment.

Neighborhood clinics and community health centers, where communities of color often get services are one-stop shops.

Patients can meet with social workers and health insurance navigators to enroll in healthcare and find other resources like food and housing.

Advocates say, - Those community health centers tend to not have enough resources and, or they're just stretched really thin.

- And the Corona virus has strained an already stressed system.

The 2021 Seattle King County clinic, scheduled to happen in October, has been canceled due to the pandemic.

The patients who would have otherwise come to seek healthcare here, we'll have to find another way.

Meanwhile, in the wake of the Corona virus, the need and demand for free and low cost healthcare continues to grow.

- [Woman] The way that health insurance is structured in this country, a lot of it is tied to your employer.

You get it through your employer or through your job.

And so when people lose their jobs, they also lose their health insurance.

- Maybe one of the best thing that will come of the pandemic, is that it is going to take our horribly strained healthcare system and bring it to the verge of collapse.

Maybe the pandemic is bringing us to that point now.

Where we're gonna have to do something.

Maybe this will be the impetus to bring us to a more rational and more affordable arrangement to help deliver healthcare.

- [Woman] It's really important in a pandemic that people have access to healthcare for lots of reasons.

We want people to get tested.

We want people to seek care if they have symptoms so that we can stop the spread.

So that they can get treated.

That's just meant that they're not able to get care when they need it.

And unfortunately that leads to further transmission of the disease.

- You're all set good job, have a good day.

- I think that the COVID-19 pandemic has shown us that we have to care about the health of all peoples.

If we leave one population unprotected that that just means we're all unprotected.

Because all of our health is tied to one another.

- [Narrator] This series is made possible in part by the generous support of Premera Blue Cross.