market failures and to better deliver healthcare services to low-income and underserved populations, including Medicaid and Medicare. Since then, there have still been increasing inequality and issues in coverage, access, cost, and quality of healthcare in America. In the United States, free clinics are a way to address this inequality and lack of universal healthcare, and as part of a health safety net. The modern concept of a free clinic originated in 1950 in Detroit and was named the St. Frances Cabrini Clinic. However, the first documented free clinic is considered to be the Haight Ashbury Free Medical Clinic in California which was started by Dr. David Smith in 1967. From there free clinics spread to other California cities and then across the United States, such as the Berkeley Free Clinic. Many free clinics were originally started in the 1960s and 1970s to provide drug treatments. Each one offered a unique set of services, reflecting the particular needs and resources of the local community. Some were established to provide medical services in the inner cities, while others opened in the suburbs and many student-run free clinics have emerged that serve the underserved as well as provide a medical training site for students in the health professions. From 1968 through the 1970s, the Black Panther Party established several Peoples’ Free Medical Clinics as part of their efforts to counter systemic discrimination against Black people in hospitals and private medical practices. In 2001 the National Association of Free and Charitable Clinics (NAFC) was founded in Washington, D.C. to advocate for the issues and concerns of free and charitable clinics. Free clinics are defined by the NAFC as "safety-net health care organizations that utilize a volunteer/staff model to provide a range of medical, dental, pharmacy, vision and/or behavioral health services to economically disadvantaged individuals. Such clinics are 501(c)3 tax-exempt organizations, or operate as a program component or affiliate of a 501(c)(3) organization." In time various state and regional organizations where formed including the Free Clinics of the Great Lakes Region, Texas Association of Charitable Clinic (TXACC), North Carolina Association of Free Clinics, Ohio Association of Free Clinics and the Virginia Association of Free and Charitable Clinics (est. 1993). In 2005 Empowering Community Healthcare Outreach (ECHO) was established to assist churches and other community organizations start and run free and charitable clinics. In 2010, the Patient Protection and Affordable Care Act (ACA) was passed