The Affordable Care Act or as many call it “Obama Care,” is now the law of the land. The monumental decision to pass this piece of legislation and convert it into law is a major step in the right direction, but it is not the full solution to solving the multiple problems with our healthcare system. However, there are significant benefits to this law, and communities like Boyle Heights will benefit tremendously. This law aims to expand access to care to the close to 50 million uninsured Americans ”“ with 2.2 million uninsured people in Los Angeles County alone, according to the L.A. County Department of Health Services. A large percentage of these uninsured individuals are Hispanic, and live in poverty. Under normal circumstances they would not have access to care. Many will now have an opportunity to seek the care they sorely need.
While this is a major victory for millions of Americans who lack access to care, it is important to educate yourself on how this law will affect you. Rest assured, this law will affect everyone. Here’s a brief introduction to how it will affect certain groups like seniors, low-income families, and some resources that they can tap into for care. For a quick tour of how different individuals and families will be affected by the law, go to this fun and informative site created by the Kaiser Family Foundation.
Seniors
Boyle Heights has a large aging population. Many elderly here lives in poverty and rely upon Medicare to “pay” for their health care. One of the earliest provisions of the new law, which went into effect starting in 2011, helps seniors to pay for prescription drugs at discounted rates. Medicare beneficiaries also do not have to pay co-pays or deductibles on preventive care ”“ a benefit that went into effect last year as well.
New Opportunities to Get Affordable Health Care
Many more Boyle Heights families will now be eligible for government-subsidized health care, as long as their income does not exceed $30,656 for a family of four in 2012.
A public program that is available for many low-income families and individuals who are currently uninsured in Los Angeles is “Healthy Way L.A” which covers both inpatient (hospitalizations) and outpatient (clinic) care. To be eligible, you must be between the ages of 19-64, be a resident of Los Angeles County, and be a US citizen or a legal resident or permanent resident of over 5 years. Some of the services that this program provides are:
Ӣ Primary Care by Appointment
Ӣ Preventive Care & Mental Health Services
Ӣ Care Management Services for chronic illnesses like Diabetes, Urgent and Emergency Medical Care Coverage.
For more information visit the County Department of Health Services Information page on Healthy Way L.A. or call 1- 877-333-HWLA (4952).
Private Insurance and the Obligation to be Insured
The Affordable Care Act also provides subsidies for working middle class families and individuals so that they can purchase a private health insurance plan. If individuals do not purchase a plan, they will face a financial penalty or tax starting in 2015.
Uninsured Single Men and Women & Families
If you are single or new to our healthcare system, you must purchase a health plan. You will eligible to purchase a health plan through a state health insurance exchange (a market of insurance plans available for purchase). Depending on your income, you may be eligible for a state subsidy to help you afford a health plan. You have the option of not purchasing a health plan, but keep in mind that you will be taxed $95 starting in 2015.
Other benefits and changes that can be expected with this new law include:
”¢ Already, under the new law, insurers can no longer deny coverage to people with “pre-existing conditions.” That means that if you have a chronic disease like diabetes or heart disease, you can still get health insurance and seek care with a doctor.
”¢ If you are under the age of 26, your parents’ insurance can be extended to you now, even though you may not live with your parents and are not claimed as a dependent on their taxes.
Ӣ Financial help to buy insurance will begin in 2014. Remember, if you are low-income, you can apply to participate in L.A. Healthy Way now.
Many opponents of the reform law have questioned whether it is constitutional to “tax” people with a fine for not purchasing a health plan. The Supreme Court upheld this provision in its recent ruling as constitutional. The tax would start at $95 in 2015 and increase to $695 by 2017. Why this “tax” you ask? This will help raise about $4 billion per year to pay for our healthcare coverage. More importantly, it will also help to ensure that more people sign up for insurance. That makes the expansion of insurance economically feasible because insurers will serve a broad mix of people, including those who are young and healthy and those who suffer from chronic illnesses. Without this “mandate” to buy insurance, it’s possible that only the sickest would sign up, making the expansion of health care unsustainable.
This law remains controversial, but it now has the stamp of approval of the highest court in the country. The Affordable Care Act was the right thing to do in my view. Millions of Americans are suffering without access to care. Health care is a fundamental right of any human being, not a privilege.
Boyle Heights and other working class communities are in dire need of access to quality healthcare services. This law does not solve all the problems with our healthcare system, but it will alleviate some of them.
Victor M. Peña is a native and resident of Boyle Heights. He has more than eight years of healthcare experience working with healthcare organizations in Santa Barbara county and Los Angeles county. He is currently completing his Masters of Business Administration with an emphasis in Management and manages a department at Good Samaritan Hospital in Downtown Los Angeles.
