Despite the admittedly creaky opening of open enrollment under the Affordable Care Act (ACA) this month, we are nonetheless at the single biggest moment in health care since the enactment of Medicare and Medicaid into law in 1965.
With any new program, there will be bumps in the road, and that’s what we’re facing now. Nothing is perfect, and everything takes time to sort out. And it will be sorted out – we predict that months from now, no one will remember website delays or outages.
What we must remember is that the ACA is the right thing to do and now’s the right time to do it. For far too long, we have left too many people in our country without health coverage, and stuck others with expensive and/or inadequate coverage.
Well, times are changing – the Congressional Budget Office estimates that there are 55 million uninsured nonelderly residents in the United States, and that 14 million of those residents will enroll in a health plan in 2014.
Closer to home, hundreds of thousands of people stand to benefit from Obamacare in Los Angeles County. But in a sense, we will all benefit.
The ACA will bring hope and health to many of our family members, friends, neighbors, teachers and loved ones who desperately need and deserve high quality, affordable health care.
For the past four years we have seen this urgent need first-hand at the annual Care Harbor clinic, a massive free clinic providing medical, vision, and dental care to thousands of people at the Los Angeles Memorial Sports Arena.
Care Harbor provides services on a large scale, offering much needed dental fillings, extractions and teeth cleaning, eye exams, prescription glasses, and medical exams, as well as health education and preventive care services, immunizations, mammograms and other health procedures. The clinic also arranges follow-up care with local community clinics and hospitals for patients who need it.
In addition to the direct care provided at the clinic, there will be a significant focus on enrolling the patients in continuous or regular care services – Covered California Medi-Cal, Healthy Way LA, and even CalFresh, the food stamp program. Yet, we know that hundreds of thousands of Angelenos will not be eligible for coverage and will remain uninsured. And for at least the first year of Covered California health care coverage, adult dental services will not be included, so there will continue to be this demand until it’s made available.
That’s why Care Harbor will unfortunately be in demand for the foreseeable future. The residually uninsured – legal immigrants for less than five years, undocumented immigrants, people who can’t afford the insurance (even with the subsidies) or who simply decline coverage and choose to pay the fine – often end up paying out of pocket for their care, or worse, going without until their conditions become dire and more costly.
The Affordable Care Act is a major step forward for our county for generations to come, but as we make history with the start of health care coverage January 1 for millions of people, we must also remember that we have an unfinished agenda to ensure health access and coverage for all in our community. Ultimately, in an ideal scenario, there would remain no need for Care Harbor or other free clinics that serve those of us who have the least.
Howard A. Kahn is the Chief Executive Officer of L.A. Care Health Plan, the nation’s largest publicly operated health plan. Don Manelli is Founder and President of Care Harbor, a Los Angeles-based nonprofit organization that helps uninsured and underserved populations by organizing large-scale, free urban health clinics.