SAN DIEGO, Calif. - The diagnosis of third stage breast cancer last December sent 49-year-old Spike Dolomite Ward, a mother of two, who describes herself as “ordinary, middle-aged and middle-class,” into a tailspin.
With no health insurance to cover her treatment, and told by insurance companies that she couldn’t get any because of her “pre-existing condition,” she and her husband got a home equity line of credit, and then tapped into their retirement savings to pay her mounting medical bills.
Ward is convinced that had she not enrolled in the state’s Pre-Existing Condition Insurance Plan (PCIP) she found out about through a friend, the consequences for her and her family would have been dire. PCIP, she said, “saved my life.”
The program, created by the 2010 health care reform law, is designed to provide affordable health coverage for people who have been otherwise locked out of the health care system because insurance companies will not cover them. PCIP also serves as a bridge to 2014, when insurance companies will be prohibited from refusing to deny coverage based on someone’s pre-existing condition.
Ward said she “outed” herself about her situation through blogs on her website and in top mainstream media. And she told her compelling story once again at The California Endowment-sponsored ethnic media briefing here July 13 on how people can start accessing the already-implemented provisions in the Affordable Care Act (ACA).
It was the seventh such briefing organized by New America Media in different parts of the state and was held only days after the US Supreme Court upheld the law’s constitutionality.
“She’s a classic example of an individual who was unaware of what’s out there in the ACA,” observed Lucien Wulsin, executive director of the Santa Monica, Calif.-based Insure the Uninsured Project, which focuses on the state’s uninsured. And, Wulsin noted ruefully, in his presentation: “Probably 90 percent of the country” is still in the dark about the law.
California has been ahead of the curve in implementing provisions in the ACA that have unrolled, as well as in preparing for 2014, when the law is fully implemented. Hundreds of thousands of the state’s 7 million uninsured people have already begun receiving some form of health coverage through the ACA since it was signed into law in 2010.
By the time it is fully implemented in January 2014, half of the state’s uninsured will receive coverage through expansions in the Medi-Cal program (California’s name for the federal-state insurance program for low-income people) and half through the Health Care Benefit Exchange, noted Wulsin.
He pointed out that 380,000 low-income people in California have already received coverage through the state’s early implementation of the expanded Medi-Cal program; another 9,000 of the so-called medically uninsurable, like Ward, are now covered through PCIP, and 420,000 young adults under the age of 26 have been allowed to stay on their parents’ health care plans.
When the online marketplace health exchange is up and running on Jan. 1, 2014, navigators will provide assistance to potential consumers, he said.
Those who are ineligible for any form of health insurance (like the undocumented), or unwilling to purchase insurance, can still access community health care clinics, Wulsin said.
Like many health advocacy groups, the faith-based non-profit, PICO, has done much in the last couple of years to “bring health reform home, to make sure underserved, low-income communities are helped,” said Hannah Gravette, a health care organizer with the San Diego Organizing Project, a member of PICO. Around 650,000 San Diegans were uninsured in 2009, according to UCLA’s Center for Health Policy Research.
Gravette said the state has received “buckets of money” to implement health care reform. Some of that money has been targeted toward the Low-Income Health Program (LIHP), which was established by the California Department of Health Care Services to help the state prepare for health care reform. It is an optional, county Medi-Cal like program that expands primary medical coverage to certain uninsured, low-income adults. LIHP will fold into Medi-Cal in 2014. Some 27,000 San Diegans have currently enrolled in LIHP, with PICO contributing to the enrollment.
But as for children in the county, 84,000 of them, who are currently eligible for insurance, aren’t insured, noted Mike Odeh, health policy advocate at the Oakland office of Children Now. Of them, two-thirds are Latino.
“Most parents lack awareness of what’s available out there, and for some others, the application process can be daunting,” Odeh said, adding: “The (Affordable Care Act) will simplify the process, allowing parents to go online and fill out the application.”
Some undocumented parents don’t know that their U.S.-born children are eligible for public health insurance programs even though they themselves are not.
Odeh also pointed out that even though Governor Brown and state lawmakers decided in June to move the 875,000 children currently enrolled in the Healthy Families Program to Medi-Cal, that won’t happen until January 2013.
More information on how to access children’s health care can be got by calling the multilingual call center at 1-877-543-7669.
中文翻譯 EspañolSACRAMENTO – Health care advocates warn that time is running out on drawing down…
Photo: Aurelia Ventura/La OpiniónTraducción al españolHealth care reform is already helping people struggling to get…
Traducción al Español한국어 번역 中文翻譯BALTIMORE -- As one of America's top 10 wealthiest states and one…
English TranslationMIAMI - Las figuras son deplorables.Uno de cada 13 niños estadounidenses sin seguro médico…
Image: Evelyn García, 26, recently aged out of her parents' medical plan. Traducción al españolEvelyn…
Video (above): New America Media conducted exit interviews with attendees at the "WeConnect" health and…