Gearing Up For The Affordable Care Act

The Affordable Care Act (ACA) is the landmark 2010 federal law that requires most United States citizens and legal residents to have health insurance starting in January 2014. It reaches a milestone today with the start of open enrollment. In our state, uninsured residents can call or visit Covered California to purchase health insurance.

You’ve seen videos on InSite discussing how the ACA affects the County as an employer. But the County has a significant role in serving San Diego County residents as well. For the County Health and Human Services Agency (HHSA), a good portion of 2013 has been spent working with State officials, local healthcare providers and community-based organizations to prepare for the law to be implemented.

What’s the County’s Role?

Although all signs to the public point to Covered California, the reality is that San Diego County residents who call the exchange’s toll-free number or apply online will be served by HHSA staff. While the State sets policies for how the exchange works, it is counties that are tasked with enrolling residents into health coverage, either through the existing Medi-Cal Program, the newly Expanded Medi-Cal Program or one of the plans available through the new Health Benefits Exchange.

In terms of new customers, San Diego County experts estimate that 220,000 individuals will be eligible for the Health Care Exchange insurance, and 111,000 individuals will be newly eligible for Medi-Cal. Additionally, they expect that there are 200,000 individuals currently eligible for Medi-Cal, but have not enrolled.  With the law’s mandate requiring individuals to be insured, many of these people will likely now enroll to avoid the penalty. That makes for an estimated 530,000 residents who may seek health care coverage through Medi-Cal or the Exchange.

How Have We Prepared?

The County has taken a number of steps to prepare for the launch of the Affordable Care Act. This includes working with the State and other counties on training staff to understand the policies, procedures and systems used to serve customers. 

County staff has also been working closely with community-based organizations tasked with getting the word out to residents about their options under the law. Locally, the State contracted with 2-1-1 San Diego, the Council of Community Clinics and Social Advocates for Youth (SAY) San Diego to do outreach and education – a tall order given the scope of change that is occurring.

To handle the increased case load, the Board of Supervisors recently approved increasing staff and starting the process to identify locations for two new Family Resource Centers, which will bring the total to 14 facilities.

Where Can People Go For Information?

What can you do if someone asks you where they should go for information about the Affordable Care Act? The best resource for information is Covered California, either online at coveredca.com or by phone at 800-300-1506. You can also refer them to 2-1-1 San Diego, the County’s local community resource and information partner, which has trained staff to assist callers.

Open Enrollment is only the first of many milestones with the Affordable Care Act. Keep an eye out for future updates on this issue.