By Anna Daniels
While Republicans are busily obstructing and attempting to de-fund (but not replace) Obamacare, California has been gearing up for the day when a significant number of its 7.1 million uninsured residents under the age of 65 can sign up for health insurance on the State’s health care exchange. That day is October 1, 2013. The insurance itself will go into effect on January 1, 2014. All Americans must be insured by tax time next year or face a penalty – 1 percent of their annual income or $95, whichever is higher.
There is a great deal at stake here in City Heights for making the enrollment period a success. There is a great deal at stake here in City Heights for making the Affordable Care Act (Obamacare) a success. There is a higher percentage of uninsured adults and children in City Heights than the county and state averages. There are fewer working adults in City Heights with insurance coverage–only 49% compared with 65% of county residents. This translates into lower levels of preventive and routine health care access– the very things that Obamacare will provide. “All new health plans must cover essential health benefits such as doctor visits, hospitalization, emergency care,maternity, pediatric care for your kids and prescriptions,among other services. ”
It is going to be a busy three months. The local nonprofit SAY San Diego has received $500,000 from the state-run exchange, Covered California, to help residents sign up for new health policies offered under the Affordable Care Act. Enrollment will be done online or over the phone. Understanding the different policies, chosing the best most affordable one and completing the enrollment can all be challenges. The state will be hiring and training “navigators” who will be able to assist with those specific issues. The plans will be available to all legal residents and businesses with less than 50 employees.
The enrollment process is the critical step in assuring coverage beginning January 1, 2014. Steve Eldred, City Heights Program Manager for the California Endowment spoke to me about the nature and scope of the the uninsured. It is estimated that there are 21,000 eligible uninsured residents in City Heights. Outreach into the City Heights community is the essential element that will assure 100% enrollment. This means identifying populations that are most likely to have a high uninsured rate and overcoming the obstacles to informing and enrolling them. Latinos are the largest uninsured population here. They are also a comparatively younger population. The fiscal health of the exchange depends upon the participation of younger, healthier enrollees. The benefits of enrollment will therefore accrue to both individuals and the system itself.
Language barriers are probably the most obvious challenge. Residents in City Heights speak a multitude of languages and the state has not translated materials into all of those languages. Immigration status is also a challenge. While refugees and asylees are largely ineligible for coverage, their native born children are eligible. This means that there will be blended families of eligible and ineligible household members in those families. Because of City Heights’ high uninsured rate among children of 11% compared to 5% county and state-wide, there will be intensive efforts to identify these children.
Eldred also identified other gaps in insurance coverage- young people, individuals who have been incarcerated and recently released, and the 40-65 year old category. The federal government has provided grants to community clinics, which have the most extensive ties to all of these populations. There is also an opportunity for our local schools to become involved. Non-profits which provide services to immigrants and the poor also need to participate in outreach efforts.
One hundred percent enrollment of eligible residents will still leave significant gaps. Ineligible refugees and asylees will still need health care services. There are also approximately 5,000 residents living here without documentation. They too will still need health care services. We should not lose sight of that. The health of individuals ultimately affects the health of our community.
Megan Burks, award winning reporter for Speak City Heights, has been running a series called Second Opinion. This series answers specific questions about Obamacare coverage. It continues to be the best source of information about what’s happening on the ground and what people need to know.
This is the time to start talking about the upcoming enrollment with our neighbors and friends and absorbing as much information as we can. It is going to take a village to make sure that eligible residents are insured under Obamacare.