Congresswoman Maxine Waters convened federal, state and county leaders on Monday morning to discuss the status of health care reform implementation in California and, more specifically, Waters' congressional district.
The verdict? There's still a whole lot of work to be done.
"Getting the word out is perhaps the greatest challenge we face over the next six months," said Waters, speaking to representatives from a host of agencies and groups, including the California Endowment, Covered California, the Insure the Uninsured Project and the Community Clinic Association of Los Angeles County.
Editor's Note: OnCentral receives financial support from the California Endowment.
Dr. Robert Ross, the president and CEO of the California Endowment, called it a "critical, critical moment."
"This is our Super Bowl," he said. "Certainly nothing this big has happened since Medicare or Medicaid. That was 50 years ago, so you do the math."
There's plenty of math to do. David Panush, the external affairs director for Covered California, offered the following figures:
- There are 40 "working days" until open enrollment for Covered California begins.
- Los Angeles County has contracted with six health insurance plans: Anthem Blue Cross, Blue Shield of California, Kaiser Permanente, L.A. Care, Molina Healthcare and Health Net.
- In California, there are approximately 5.3 million uninsured.
- Covered California will require its plans to cover 10 essential health benefits.
- The City of Bell has the highest concentration of any zip code in the state of folks who are eligible for a Covered California subsidy.
- 2 in 3 potential Covered California consumers live in Southern California.
Panush pointed out that only about 30 percent of those who are eligible will self-enroll in Covered California, meaning outreach is going to be a major part of getting people into the program.
Getting the word out
Sherrie-Ann Gordon, the manager of multicultural markets and specialty programs for the AARP, was also present at Monday's meeting. She detailed what she calls her organization's "ground game."
"For us, it's not just about educating people with the right information," she said. "It's about debunking the myths."
Gordon mentioned an "ACA (Affordable Care Act) Academy," AARP's informal way of teaching people the "basics" of health care reform.
"It's just the things you need to know if someone asks you a question," she said, pointing to places where that sort of conversation may happen – a church, for example.
Gordon said AARP's national office is also putting out materials – complex information pared down to "its simplest form" – and creating webinars designed to inform folks on the ins and outs of health care reform.
"Not everybody has digital access, but everybody has access to hubs," she said, referring to community spaces where a webinar could be shown to a lot of people at once. That's the same idea behind "tele-town halls," where AARP wants to get thousands of people on the phone at once to explain health care reform and take questions.
"For us, it's about scaling up," said Gordon. "Educating 50 [people] is great, but we've got to get to 50,000."
The doctors are 'nervous'
Sherrie-Ann Gordon was speaking figuratively, but in Los Angeles, that number will be closer to 500,000. That's according to Rockard Delgadillo, the CEO of the L.A. County Medical Association, which represents area physicians.
"The doctors are ready to help," said Delgadillo. "And they are nervous. There will be 500,000 newly-insured coming our way."
He offered some context to the figure.
"Well, that's the size of the entire city of Sacramento," he said.
The U.S. is in the midst of a physician shortage, said Delgadillo, and doctors are getting older. When the Affordable Care Act inevitably complicates things, he explained, those older doctors may just retire.
"Going to see your doctor is not the easiest thing to do today," he said. "Now add 500,000 newly-insured on top of that."
The concern of community clinics
Safety-net clinics like South Bay Family Health Care want to make sure some of those newly-insured come through their doors. John Merryman, the health center's senior director for marketing and public relations, says it is South Bay's mission to provide care to people who can't afford it. In order to provide that sort of uncompensated care, the clinic also needs to treat people who can afford it.
But before those patients can pay for care, they have to enroll – and that's the challenge, especially with a patient population that tends to be more transient than it is in other places.
"We have phone numbers that are out of order, we have addresses that aren't accurate anymore," said Merryman. "We have to find a way to reach these folks."
That may mean making appearances at – again – their churches, for example.
"We know everyone gets their information differently," said Louise McCarthy, the president and CEO of the Community Clinic Association of Los Angeles County. "The clinics really want to make sure the clinics remain the providers of choice once [patients] get insurance."