Healthcare reform ready to be implemented locally

Surprise, surprise. The Obamacare roll-out is very much open for business to everyone in Sonoma County and all across California. Thousands of county  residents became instantly eligible for expanded Medi-Cal benefits on Oct. 1 and all medical insurance plans will meet new minimum standards of coverage and service beginning Jan. 1, 2014.
In stark contrast to the political bickering and web site failures at the federal level and back in Washington, D.C., dozens of new “access coordinators” are enrolling people at local health care clinics, county human services offices, and on-line at two “up and running” county and state web sites.
“We’re definitely open for business,” said Peter Lee, executive director of Covered California, the new healthcare coverage exchange and public marketplace created this year by the state to deliver information and enrollment tools for the federal Patient Protection and Affordable Care Act (Obamacare.)
“Yes, it is still confusing, but it’s not a mess. If you live in California you don’t need the federal healthcare.gov web site,” said Lee.
Under the federal reforms, millions of people will be eligible for no-cost medical coverage under Medi-Cal. Others with household incomes less than four times the federal poverty level ($94,200 for a family of four) will be eligible for tax subsidies and participation in the new open market exchanges. People with pre-existing medical conditions can no longer be denied coverage by insurance companies and by next year (2015) all employers with 50-plus employees will be required to provide healthcare coverage to all full-time employees.
At the state web site californiaCA.com, individuals and small business owners can survey all the new healthcare options, test drive rates, check income eligibility for Medi-Cal and new federal tax subsidies and register for a personal call back.
California is one of just 16 states that elected to form its own exchange marketplace. The other 34 states, all led by Republican governors, declined the option and must wait for the federal government to rebuild its web site launch and enrollment services.
The County of Sonoma has a companion web site to californiaCA.com with most of the same information and services at www.sonoma-county.org/healthcarereform.
Under the new requirements of Obamacare, everyone must secure healthcare coverage or pay a $95 penalty next year (2014.) Open enrollment started Oct. 1 and runs through March 31, 2014. Persons enrolling by Dec. 15 will begin to receive services on Jan. 1, 2014.
“This is flat-out revolutionary,” said Bob Aita, benefit broker at Aita & Associates in Sebastopol. “This (Obamacare) is addressing a lot of the disfunctionality we’ve been dealing with for years.”
Aita, who has participated in several public forums on the topic, said he endorses the massive federal healthcare reforms of Obamacare, but said he would have preferred extending the federal Medicare to all ages. “For the most part, this was really, really needed. When we’re talking about Obamacare, we need to focus on the facts and not the man (the president.)”
While the federal government struggles with a failed launch of its healthcare.gov web site, 2.2 million people already have visited the californiaCA.com web site here.
“We are creating a new culture of coverage and access,” said Abraham Daniels, of the county public health department. He said his agency and other partners in a new community-based healthcare network have set a goal to enroll at least 25,000 residents in health coverage and insurance programs by the end of next year.
Currently, there are 70,000 county residents without healthcare insurance. Of that total, 50,000 are eligible for some form of no-pay or subsidized government plan, including 18,000 new Medi-Cal patients who will mostly be served at the smaller federally-certified health centers.
“About 35 percent of our clients have no insurance,” said Beatrice Bostick, executive director of Alliance Medical Center, serving Healdsburg and Windsor. “We expect half of them to now be eligible for Medi-Cal. In California we have done a better job (on Obamacare.) We’re definitely well ahead of the game.”
Alliance, Cloverdale’s Alexander Valley Clinic, West County Health Centers in Guerneville, Occidental and Sebastopol and other clinics in the Redwood Community Healthcare Coalition have hired or trained over 200 new eligibility workers with federal grants. A new center is open in Santa Rosa with 42 newly-trained staff. A main phone line is being staffed six days a week for both English and Spanish speaking people. The number is 1-(877) 699-6868. The direct number for Alliance is 433-5494.
Callers speak with a live, trained worker, not a computer. Walk-ins at the main center on Airport Blvd. north of Santa Rosa or at the community clinics are welcome. More than a dozen public forums have been held around the county, with more already scheduled.
Alliance Medical Center volunteers are handing out information at the Windsor Wal-Mart. In the West County, health center staff and Americorps workers have visited schools and some businesses.
At Covered California, Sonoma County residents will find various individual and family plans offered by Anthem, Blue Cross, Kaiser Permanente, Health Net and Western Health Advantage. Small business employers have a similar set of plan choices.
People already covered can keep their same family doctor, but should check any new plans for a list of participating physicians and hospitals.
People already covered by a healthcare plan at their workplace do not have to do anything, so long as their employer maintains the coverage.
“I like the increased competition and options,” said Aita. “People need to figure out what their health coverage is worth to them. This is the first time for many people. You have to consider what might happen without coverage. Some people will be paying more but that is because the new laws require the insurance companies to provide new basic coverage.”
“We’re seeing more and more people coming to us to both enroll and learn more about their other options,” said Jeremy Robenolt, of West County Health Centers. “People are finding out about what else we offer and how affordable it can be.” She said her clinics expect to enroll 3,700 people to Medi-Cal while assisting many others with all the new options for individual insurance or sliding scale services.
Open enrollment continues through March 31, 2014. To explore options, individuals need a zip code, size and ages of household and total household income.