Health Reform “Bridges” Sacramento Man from Pain to Care

Health Reform “Bridges” Sacramento Man from Pain to Care

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Photo: Arsenio I. Jimenez, MD, examines Clifford Roberson at Sacramento’s Molina Medical Clinic. (Courtesy of Molina Healthcare)

SACRAMENTO, Calif. – Clifford Roberson’s pain has persisted for a quarter century since the day he was unloading a truck in the rain with a forklift for his job at the California Almond Growers Exchange in downtown Sacramento. That’s when a co-worker ran into him with another forklift.

“I was young back then,” said Roberson, now age 51. “I jumped off the fork lift and started arguing and stuff.”

His supervisor sent him home for the rest of the day.

“And it hit me that next day. I could barely get out of bed,” Roberson said.

Constant Pain 25 Year Later

Now that it’s 25 years later Roberson realizes that he probably should have taken an ambulance to the hospital right when it happened.

The company covered his treatment following the accident, but Roberson was never able to go back to work. To this day he is constantly in severe pain in his left shoulder, neck and middle to lower back.

For years Roberson paid his bills by working as a day laborer doing odd jobs with companies like Labor Ready. He made do with over-the-counter medication, such as aspirin for his pain, since he had no health insurance to see a doctor

“I just couldn’t do it no more in 2006,” Roberson said.

He stopped working and moved in with his adult daughter. He’s been trying to enroll in Social Security’s Supplemental Security Income program that pays benefits to disabled adults but he was denied at his last hearing.

“I thank my daughter ’cause she works and she’s basically looking after me, but I would love to contribute to paying the rent and some of the bills,” Roberson said.

For the past eight years Roberson has gone to community clinics and emergency rooms for his health-care needs, until the beginning of February when he walked into a Molina Medical Clinic in Sacramento seeking medication for his pain and treatment for a stomach problem.

First, the staff assessed his eligibility for safety-net health coverage. Roberson’s income, although very low, was a little too high for him to qualify for Medi-Cal, California’s version of the federally funded Medicaid program that provides coverage to certain very impoverished people and individuals with disabilities.

But he did qualify for the Sacramento County Low Income Health Program (LIHP).

The state created LIHP in 2012 to enroll Californians early, who will qualify for more coverage once federal health care reforms go into effect in 2014. On New Years Day, Medi-Cal will expand to cover people who can’t afford health-care insurance as mandated by the Affordable Care Act. Meanwhile, people like Roberson don’t have to wait for medical help because of LIHP.

By Jan. 1, an estimated 880,000 additional people in California, such as Roberson, will qualify for Medi-Cal under the new terms of the program, according to a study released jointly by the Center for Labor Research and Education and Center for Health Policy Research at the University of California at Berkeley and Los Angeles, respectively.

Bridge to Reform

LIHP is a part of the state’s ‘Bridge to Reform’ efforts to prepare for the full implementation of the federal reforms. The program provides federal funding for counties to create a ‘bridge’ health program for residents that qualify for the Medi-Cal expansion.

Sacramento County contracted with Molina Healthcare to administer the program because of the clinic’s proven track record operating a health plan for Medi-Cal enrollees.

After the first week of February, 7,339 low-income childless adults between 19-64 years of age had enrolled in LHIP. Of those currently enrolled, about one-third are white, 21 percent are black, 12 percent are Asian, eight percent are Hispanic and one percent are Native American. A little less than eight percent identified as other or multi-race, while 15 percent of enrollees did not report their race.

The county expects 10,000-14,000 residents will enroll before they fold the program into Medi-Cal in 2014. They are also transitioning beneficiaries of the County Medically Indigent Service Program into LIHP.

“Tremendous work has gone into getting us to this point,” said U.S. Rep. Doris Matsui , D-Calif., at the program’s launch last October, “LIHP is a true testament to the commitment these providers in our region have to serving those in need.”

Once Molina staff enrolled Roberson they gave him a supply of the prescription painkiller Hydrocodone and scheduled a doctor’s appointment the following week to address additional stomach problems he’d been dealing with.

He’s been to the emergency room twice and lost 20 pounds in the past six months because of stomach pain, incontinence and nausea.

“I can’t keep nothing down,” Roberson said.

He hopes the Molina doctors can give him a diagnosis and treatment plan.

The painkillers for his back and shoulder pain have already made a big difference but the one pill he takes in the morning doesn’t last all day.

“By the time nighttime come I’m in agony,” Roberson said. He is hoping to increase the prescription to three pills a day.

Mainly Roberson is relieved to be enrolled in LIHP and to be in the care of the Molina doctors.

“It was either Molina, or I was going back to the emergency room,” Roberson said.

This report was made possible by funding from The California Endowment and is part of New America Media's series on Obamacare.

 

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