2013-02-20 09:00:00

Low-Income Workers Get Insurance Through Healthy Way LA

en espanol

LOS ANGELES--María Barrera, 64, a native of Mexico, has worked all her life in minimum-wage jobs that don’t offer health insurance in factories, warehouses and, in the last few years, as a kitchen assistant at a school in El Monte, Calif.

Still too young for Medicare, she is among the 200,000 people in Los Angeles County who currently has public health insurance through the Healthy Way LA (HWLA) program financed by the expansion of Medi-Cal (California’s name for the low-income Medicaid program), as a result of the Affordable Care Act (ACA), or “Obamacare.”

A Positive Change

Barrera has been enrolled in the HWLA program since 2011 and said she has seen a positive change in her health since then.

“I didn’t have any [health insurance] until now. I paid what I could when I felt bad or when I was getting sick. Sometimes it cost me $300 for a doctor’s visit and blood tests and $20 for each medicine,” said Barrera. She went to different private clinics and never had a family doctor.

A friend of hers told her to go to AltaMed, a nonprofit community care provider, to see if they would help her for free. The clinic staff helped her fill out an application for HWLA, and Barrera was able to qualify because she has a low income and is a legal resident.

A year and a half ago, Los Angeles County got special permission from the federal Centers for Medicare and Medicaid Services to expand Medicaid coverage as part of ACA’s health care reforms.

The County Department of Health Services gave Healthy Way LA its name and divided it into two programs. One receives funding directly from the federal government and requires people to present proof of citizenship and legal documentation. The other is much more flexible because it is funded by the county.

Amy Gutiérrez, director of the Los Angeles County Department of Health Services’ Community Partners program, said that of the 200,000 people covered under Healthy Way LA, 60 percent qualify for the HWLA match in federal funds. The rest are patients who don’t meet the requirements of citizenship or legal residency and are treated in community clinics. The low-income and undocumented patients who are part of the county’s health services network remain under LA’s Outpatient Reduced-Cost Simplified Application plan.

“It’s very easy to figure out if the person qualifies for a HWLA match [federal funds] or is included unmatched [paid by the county] … The application is easy to fill out and they can do it directly with the community clinics or in the county clinics. These are the people who in 2014 will qualify for the Medi-Cal extension,” Gutiérrez added.

Her “Medical Home”

Barrera has finally been able to control her high blood pressure, which occasionally causes her headaches and dizziness.

She added, “I am really grateful for the clinic and that program because whenever I have an appointment they treat me very well. My doctor is very good and is always looking for ways to improve my health. When they do tests it’s because I need them and not to get more money out of me like in the clinics I used to go to.”

AltaMed has become Barreras’ “medical home,” an approach to health-care delivery emphasized in the ACA that coordinates a patient’s continuity of care through his or her primary care doctor.

Gutiérrez said that under the new model of care that HWLA is implementing, the hope is that people will have a medical home, whether at a county clinic or a community clinic like AltaMed where they can go to prevent diseases or when they are facing a health problem that isn’t a life or death issue.

This program requires qualified participants to live in Los Angeles County for at least five consecutive years, be an adult between ages 19 and 64, not have minor children, be a citizen or documented resident of the U.S., and have an individual income at or below the federal poverty line of $1,239 a month.

Benefits include:
· Outpatient and inpatient services
· Primary care by appointment
· Access to pharmacies to fill prescriptions
· “Medical home” assigned to a clinic near your home or work
· Preventive care
· Mental Health Services
· Access to specialists
· Care for chronic diseases like congestive heart failure or Diabetes

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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