SAN BERNARDINO, Calif. - A health insurance company in California refused to enroll a woman simply because she had freckles on her face they believed could potentially turn into skin cancer one day.
Come Jan. 1, 2014, insurance companies will be banned from denying health care coverage, or limiting coverage or charging higher premiums to people under 65 with pre-existing conditions, under the 2010 Affordable Care Act (ACA), noted Nancy Gomez, program director for the Southern California chapter of Health-Access, a health care advocacy group.
Gomez was speaking at The California Endowment (TCE)-sponsored ethnic media briefing organized by New America Media at the Arrowhead Regional Medical Center building here April 12.
The briefing was one of many TCE is sponsoring statewide to educate and get ethnic communities to take advantage of the ACA provisions that have already kicked in. Most of the other of the provisions will launch on Jan. 1, 2014.
“Already, 2.2 million kids have benefited from the pre-existing condition provision,” Gomez told the roomful of ethnic media reporters in attendance.
Other benefits that Californians have already gotten from the provisions in the ACA include:
• About 356,000 young adults under 26 have been allowed to get on, or remain, on a parent’s employer-based insurance plan.
• Some 6.1 million Californians now get preventative health care without cost-sharing.
• More than 8,600 Californians who were turned down by insurance companies are now getting coverage through a Pre-existing Condition Insurance Program (PCIP).
Although not many are well informed about the benefits the health care reform law provides American citizens, one of the less well known programs in the law is the Low Income Health Program (LIHP) that children can access when they age out of Medi-Cal (the name California uses for the federal-state run Medicaid program for the low-income), observed Jessica Rothhaar, lead health care campaign organizer with PICO California, the state’s largest community organizing group. Children get bumped off Medi-Cal when they turn 18.
All but 10 of California’s 58 counties have launched the LIHP program that will fold into an expanded version of Medi-Cal on Jan. 1, 2014. Those enrolled in LIHP pay about $11,000 a year in premiums.
The health care reform law will eliminate some of Medi-Cal’s stringent requirements when it expands, Rothhaar pointed out. For example, ACA will do away with the asset test (requiring families to have less than $2,000 in countable assets) to receive Medi-Cal assistance. The law will also eliminate the requirement that only individuals with dependant children can enroll.
Rothhaar urged the media participants to put the word out in their communities that the state’s 400,000 to 700,000 children who are eligible for either Medi-Cal or Healthy Families (the children’s low-income health insurance program for those whose parents make too much to qualify for Medi-Cal) should enroll. Of those children, she said, 73 percent are citizens, and half of them have parents who are citizens. Parents should not worry that enrolling their children in public health programs will “count as a public charge,” because it won’t, Rothhaar said.
The ACA, she said, hopes “to have a culture of coverage,” a message that must go out to young people.
The U.S. Supreme Court is expected to announce its decision in June on whether to uphold the ACA or overturn parts or all of it. A number of states have challenged the law, saying some of the provisions are unconstitutional.
Gomez sent participants away with the reassurance that even if the law is upended, the Brown administration has promised to continue implementing many of its provisions.