October League Day Program
Speaker: Gerald Kominski
Professor, UCLA School of Public Health
Director, Center for Health Policy Research
Affordable Care Act: Implementation, Issues, and Implications
Women’s City Club, Pasadena, CA
Thursday October 3, 2013
Our League Day focus on October 3, 2013, was the Affordable Care Act: Implementation, Issues, and Implications. The Affordable Care Act (aka Obamacare) mandates that most citizens and legal residents have health insurance beginning on January 1, 2014. More than 80 League members and friends gathered to listen to Professor Gerald Kominski, UCLA Fielding School of Public Health and Director of the Center for Health Policy Research, explain how uninsured and underinsured Californians can sign up for health care, how much it will cost and what coverage options are available. The roles of the new regulated market-place or exchange, Covered California, and the Expanded Medicaid (MediCal) program were also discussed.
Starting October 1, 2013, Covered California has been offering to Los Angeles County residents (excluding Palmdale-Lancaster area) 8 private insurance plans with 4 tiers of cost and coverage (Bronze, Silver, Gold, and Platinum) via phone, internet, mail, or in-person visits with trained community “assisters.” Premium subsidies are available for individuals and families with incomes below 400% of the federal poverty level and who are not eligible for MediCal. We learned that there are 6.5 million adult Californians under the age of 65, and 2.6 million of them are eligible for subsidies. Medicare recipients are basically unaffected by the Affordable Care Act. Also, excluded by federal law are more than 1 million undocumented Californians, who must pay for private medical care or seek it through certain community clinics or county hospitals.
Whether offered through the exchange or privately or through employer-purchased plans, the Affordable Care Act mandates the insurance carrier to offer plans with 10 Essential Benefits and free preventive services; places a cap on out-of-pocket expenses; forbids annual or lifetime caps; and forbids denial or extra charges for “pre-existing conditions.”
Employers with 50 or fewer employees are not required to participate. Larger employers will be required to offer affordable health insurance to employees who work 30 hours or more per week in 2015. Currently, only 2 states mandate employers to offer such plans: Massachusetts and Hawaii .
Healthcare providers in the Pasadena Area are gearing up to provide an enhanced program of education and outreach, which targets the uninsured and underinsured in the community. The campaign is called Covered Pasadena, with a yellow umbrella as its logo, and five local outpatient clinics participating. CHAPCare, a program of the Pasadena Health Department, is leading this effort to enroll the uninsured in MediCal and Covered California plans. Steven Abramson, Marketing Manager for CHAPCare, presented an overview of the Pasadena effort, assisted by Mary Donnelly Crocker, Executive Director of the local partner agency, Young & Healthy.
Download the event flyer here: October Flyer