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Health Care Reform



Health care leaders in various California regions are preparing for a surge in new patients when the Affordable Care Act expands health insurance coverage in 2014, U-T San Diego reports.

Details of Coverage Expansion

Under the ACA, California will expand access to Medi-Cal -- the state's Medicaid program -- and establish an online health insurance exchange (Sisson, U-T San Diego, 11/26). The exchange -- named Covered California -- primarily will serve individuals and small businesses,

According to exchange officials, 2.6 million California residents will be eligible to purchase subsidized health insurance on Jan. 1, 2014, while an additional 2.4 million residents will be newly eligible for coverage through Medi-Cal.

Concerns About Expansion

Ted Mazer -- communications director of the San Diego County Medical Society -- said that there likely will not be enough doctors to manage all of the new patients seeking health care services, citing the current shortage of local primary care physicians.

He said, "We know that, for the Medi-Cal population, for the newly insured, those folks are being dealt a false promise," adding that the state is saying, "'Here is your insurance, go find a doctor,' but we know that even as things are today, current beneficiaries can't find a doctor."

Mazer said that new patients who cannot find a doctor likely will end up going to the emergency department for care, which many patients already do.

He added that the state is "going to complicate the care for the patients who currently have some access because [it will] flood the market with more people with a Medi-Cal card" without improving the health system's infrastructure.

Some hospitals and health systems are considering changing their operations in preparation for the launch of the exchange but are waiting for more information about how it will function.

Paul Viviano -- CEO of UC-San Diego Health System -- said that hospital officials are deciding whether to expand primary care offerings in the community. He said they are unsure whether implementation of the exchange would necessitate "increasing primary care infrastructure," noting that "it's a little too early for us to say definitively."

Clinics Predict Fewer Difficulties

Gary Rotto -- director of health policy for the Council of Community Clinics, which represents 16 neighborhood health centers in the San Diego region -- said he believes that the new patients will arrive at a more manageable rate. He said, "There will be an initial crunch, but we believe that we can work people into the system and provide the care that they need at our clinics."

He said that certain clinics already have begun embracing a new model of primary care delivery in which doctors supervise large teams of health care workers. Rotto said the new model is cost effective, especially for managing chronic diseases,

Source: California Health Line.  For information visit: