NAM Coverage

Despite ACA, Thousands Show Up at Free Health Fair

ANAHEIM, Calif. – The throngs of people who turned out at last month’s health fair made one thing clear: Despite the Affordable Care Act (ACA), many Americans still can’t access health care.

Jackie Mason said she had been waiting for nearly four months to get an appointment with a primary care doctor. She enrolled in her insurance plan about a year ago after being uninsured for two years. More than once she considered going to the local hospital emergency room, she said, especially when she had episodes of dizziness she believed were triggered by her hypertension and diabetes. But she knew from experience that one visit to the ER could set her back by several hundred dollars.

“I go from welfare check to welfare check and that money is barely enough to put food on my table or cover my rent,” said the 45-year-old African-American woman, who lives in a public housing project about an hour away from here. “By luck, I found out about this health fair.”

Mason was among more than 2,000 people who went to the ninth annual Free Health Fair co-sponsored by the City of Anaheim and the Anekant Community Center, May 29-31. This year, for the first time, organizers teamed up with Remote Area Medical (RAM), a Tennessee-based nonprofit that has been taking its mobile clinics to cities across the United States since 1985.

Some of those who came had health insurance but, like Mason, couldn’t cope with the wait time to see a doctor. Others lacked insurance, or had coverage that did not meet all of their needs, or were on plans where the co-pays were too high.

The line outside the cavernous Anaheim Convention Center clearly indicated that despite the ACA, whose aim was to make health care accessible to all legal American residents, hundreds of thousands of people have fallen through the cracks.

By the time the three-day event ended, organizers had provided a total care value of $337,188, according to RAM California.

More patients on Medi-Cal, same number of doctors

Mason, like one-third of the state’s population, is on Medi-Cal, California’s name for the health insurance program for low-income people, known as Medicaid in the rest of the nation. She was able to get on to it, she said, when California opened the program to childless adults like her a year-and-a-half ago under the ACA.

Expanding the Medi-Cal program has swelled its total enrollment to 12.3 million, an increase of 3.7 million people since the implementation of the ACA. But there has been no proportionate increase in the number of primary care doctors in the state’s Medi-Cal network, a situation that health care advocates say is because of the state’s low reimbursement rate -- among the lowest in the nation.

“Medi-Cal is very difficult to access,” said Dr. Jim Keany, an emergency medical care specialist and head of RAM California, who was among the more than 1,000 volunteers at the fair. “Because of poor payments, not many doctors want to accept Medi-Cal patients.”

Dental care – a ‘shortcoming of the ACA’

No one who came to the fair was asked for an ID, or questioned about their immigration status or income level. Instead they were asked a simple question: What can we do for you?

The bulk of those who came to the fair wanted to fix their teeth or get prescription eyeglasses. On all three days, every one of the 60 dental chairs RAM had provided was occupied from the time the fair began at 7 a.m. and ended at 4 p.m. The whirring sound of drills and cleaning instruments pierced the air.

RAM founder Stan Brock said even many working Americans are in desperate need of dental and vision care, which are not adequately covered benefits for adults by Obamacare. Unmet dental needs can lead to serious medical conditions, he said.

“It’s a shortcoming of the ACA,” observed dentist Dr. Ramesh Kothari, during a short mid-morning break.

The state agreed last year to restore Denti-Cal, the dental program for its Medi-Cal patients that it had eliminated in 2009 for budgetary reasons, but only partially. It does not cover gum treatment, rear root canals, or partial dentures for one or a few missing teeth.

Juan Aguilar of Baldwin Park, Calif., an uninsured immigrant originally from Mexico, had come to the clinic for some fillings because he said he couldn’t cope with his toothache. He hadn’t seen a dentist in three years.

Evangelina Munoz, 41, of Anaheim, said even though her inflamed gums had been bothering her for many months, she feared going to the Emergency Room because of her undocumented status. Her neighbors told her that all of her other health issues, including her high blood pressure, could have been caused by her dental problems. The free health fair, she said, couldn’t have come at a better time, because the pain had become severe in the last couple of weeks.

“I waited for several hours to get a token and I’m exhausted,” the mother of three said. “After I get my teeth attended to, I will go for a vision check. My vision has been blurry for the last seven years.”

Fair volunteers tried to persuade those who came for dental and vision care to take advantage of other services offered -- blood pressure checks, kidney function level, blood work, mammogram and pap smears, acupuncture, tattoo removals and even Ayurveda. One Hispanic woman said she was glad she listened because she found out that her cholesterol and blood sugar levels were high.

Anaheim resident Maria Sanchez, 50, who waited for five hours to get in, said through an interpreter that her undocumented status barred her from enrolling in Medi-Cal. The co-payments she has to make at the free community clinic in her neighborhood are unaffordable, she said, so most of the time she just takes home remedies to treat her blood pressure and GERD – a chronic digestive disease.

“They tell me the GERD could lead to cancer,” Sanchez said.

Forty-six-year-old Nick Bell, a former Raiders player, who has been on disability for more than 10 years because of the injuries he sustained on the football field for four seasons, said his Medicare plan covers only teeth cleaning and one visit to the eye doctor each year. The dental work he had done at the health fair on day one and two probably would have cost him a couple of thousand dollars at least, he said, and the vision check he was scheduled for, a few hundred dollars more.

Kothari recalled one of the patients he had seen earlier that morning, an uninsured African-American man who had infected gums that had caused one side of his face to swell.

Kothari said the infection had spread so deep that he had to extract a tooth.

“The pus came gushing out like a faucet,” he said.

Volunteers at the fair referred those who needed follow-up care to Lestonnac Free Clinic at nearby Orange, said Dr. Nitin Shah, another volunteer.

Mason, who came for a physical, ended up getting her eyes checked as well. In her hand was a brand new pair of prescription glasses.

“I stood in line from 4 a.m. to make sure I got a token,” she said. “Even though I’m exhausted, I’m sure glad I came.”

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