Sosepa Tonga recalled the day last year when she went to a free clinic in Menlo Park seeking medical care. A new immigrant, she did not have health care coverage.
“I was so sick; all my bones were aching. … They said it would take two weeks to get an appointment,” she said.
Tonga learned she is on the edge of diabetes. Her eldest daughter, Anya, has asthma that needs to be kept under control.
Tonga’s family could benefit from the federal Affordable Care Act, which was mostly upheld by the U.S. Supreme Court on June 28. The act will expand who is eligible for Medi-Cal, and Tonga is one who will be able to get coverage.
Anya, 18, is currently covered under Medi-Cal and will be through age 21. But as an adult, she will “age out” of Medi-Cal and would likely have difficulty getting private insurance due to her pre-existing condition of asthma.
Under the Affordable Care Act, young people who are currently eligible for Medi-Cal will continue to qualify as adults if they have an income below 138 percent of the federal poverty level. And, insurance companies will not be allowed to deny coverage to people with pre-existing conditions, under the federal law.
If Tonga were to get a job with a health plan, her daughters would be covered until the age of 26, under another provision of the federal act.
Ravenswood Family Health Center in East Palo Alto helped Tonga and her family to receive their current benefits. Tonga is covered through San Mateo County’s Access and Care for Everyone (ACE) program for indigent residents.
She’s one of more than 8,000 people currently enrolled in the county program, which will transition from ACE to Medi-Cal by Dec. 31, 2013, said Srija Srinivasan, director of strategic operations at the San Mateo County Health System.
San Mateo County officials estimate that approximately 47,000 uninsured county residents will be eligible for new support under the Affordable Care Act. The number includes an estimated 34,000 residents who will qualify for subsidies through the Advance Premium Tax Credits program to purchase insurance through the California Exchange and an estimated 13,000 who will qualify for free health insurance through Medi-Cal, she said. The county expects to continue the ACE program for persons who don’t qualify under the Affordable Care Act, she said.
The Medi-Cal expansion will extend to all low-income, documented residents with five or more years of residency with household incomes at or below 138 percent of the federal poverty level (about $15,000 in annual income), Srinivasan said.
Currently, the Medi-Cal program is only available to certain segments of the lowest income population, such as children, parents, the elderly and individuals with disabilities.
“Many low-income residents who are unable to afford health insurance today will be eligible for Medi-Cal for the first time,” Srinivasan said.
The federal act also puts a high premium on preventative care, which will benefit patients like Tonga. She takes nutrition classes and joined an exercise program to manage her pre-diabetes condition, she said.
“When I go home and I sleep at night, I’m not snoring, and after dinner there’s no eating at nighttime,” she said.
In addition to better health, guaranteed insurance will enable Tonga’s family to better avoid financial crises like the one that occurred last September, when Anya had a major asthma attack. Life-saving medications cost Tonga more than $600 out of pocket, a bill that she has been paying off $20 each month, she said.
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oh joy….47,000 more on the dole….obamacare is going to bankrupt us all…
ann: “….obamacare is going to bankrupt us all…”
Any actual facts, or ya going to stick with fact-free Fox talking points? Or even the oppositions plan for healthcare.
I’d even settle for consistency — show me a post under your name prior to 2009 that complains about the deficits incurred under Bush with any of these causes:
– Medicare Part D – unfunded, with money borrowed from China
– two wars, always under an ’emergency’ supplemental bill every year (like we were surprised that we were at war every year!) again unfunded
– tax cuts for the wealthy, including cutting capital gains tax…. maybe the first time that any civilization has ever had massive tax cuts in time of war
Remember: Bush inherited a couple years of budget surplus, and gave America it’s first trillion dollar deficit, along with consecutive months of 3/4 million job losses.
Show us your consistency. Show us the links to your posts.
Thank you, Mr President, for helping so many millions of Americans!
Ann –
You are aware aren’t you that every other industrialized country in the world provides health care to all its citizens at costs that are far less than we pay in the US. Universal Health Care, far from bankrupting these other countries, has given them a healthier workforce and more competitive industries since the companies aren’t the primary source for worker healthcare.
The per capita cost for health care in this country was approaching $7,500 per year in 2007. The next most expensive was Sweden with a per capita cost of $4,500. Reference at http://en.wikipedia.org/wiki/File:Total_health_expenditure_per_capita,_US_Dollars_PPP.png. Could it be that it’s the 20% markup for administrative costs & profit that the insurance companies bleed us for that is making healthcare so unaffordable for so many?
As for bankruptcy, you must be aware that health emergencies drive over half a million American families into bankruptcy each year because they are either uninsured or under-insured. In other industrialized countries, bankruptcy for health reasons is virtually unheard of.
Obamacare is not perfect but it is a reasonable attempt to begin to get healthcare under control and make it more affordable for all Americans – not just those who are wealthy or lucky enough to have good benefits through their work.
to ann from another community:
What kind of insurance do you have? One of the millions with life time insurance paid for by the public? Someone young enough that you can’t envision being laid off four months before you could qualify for life time group insurance rates. Or maybe you inherited insurance? These are tough times for people who have worked their whole life and never saw themselves as potentially uninsured.
To the weekly – can someone do an article showing the wide spectrum of those that will benefit. The more this topic gets intertwined with immigration, homelessness, etc., the more we will have naive people thinking this only benefits a segment of the society that they apparently don’t care about. There is a lot more to this topic, but no news group has addressed the bigger picture.
We already “pay” for health care for the uninsured – its called the Emergency Room plan. The uninsured go to the ER for care – often much sicker than they would be if they had access to health care and insurance. Guess who pays for it? Those of us with insurance pay more for our insurance to cover the cost of those without.
Once again, thank you, Palo Alto Mom, for pointing out this simple but important truth. I recently discussed the same issue w/a friend who said that he believes health care is a privilege & that he didn’t want to pay for the health care of others. I said that people need to accept it as a right & that we already pay for the insured. I personally prefer to see them suffer less, get the help that they need and return to health.
Currently, we are helping a neighbor who has worked his whole life & didn’t have coverage. He is recovering from a health crisis & thanks to Ravenswood Health Center, he’s alive, has coverage AND not having to declare bankruptcy due to medical costs. He’s not an immigrant – his family has been in Calif longer than most.
same ol’ silliness. We have MediCal for LEGAL immigrants. We have charity hospitals and clinics ( note the comment about Ravenswood above) for the undocumented or for what MediCal doesn’t cover. This was never about covering poor citizens. It was all about 10 million citizens who were deemed unable to afford insurance, but above the MedicAid/Cal line. All this for 3% of the population. All this when there were such simple fixes.
Well, it is here now. Enjoy the fall-out. It will be intense.
Such hyperbole and absurdity fron the above post – “All this for 3% of the population.”
What on earth are you trying to peddle?!?!?
This says it all “All this when there were such simple fixes.” Then why haven’t the ‘simple fixes’ happened in the last 20 years? What were the Bush/Cheney fixes?
Why did it take a Romney to fix it in Massachusetts?
You do like Romneycare, don’t you?
Back to the 3% only absurdity…. from another post on the Affordable Care Act, the President takes apart the Fox 3% talking point:
– “First, if you’re one of the more than 250 million Americans who already have health insurance, you will keep your health insurance — this law will only make it more secure and more affordable.
– Insurance companies can no longer impose lifetime limits on the amount of care you receive.
– They can no longer discriminate against children with preexisting conditions.
– They can no longer drop your coverage if you get sick.
– They can no longer jack up your premiums without reason.
– They are required to provide free preventive care like check-ups and mammograms — a provision that’s already helped 54 million Americans with private insurance.
– And by this August, nearly 13 million of you will receive a rebate from your insurance company because it spent too much on things like administrative costs and CEO bonuses, and not enough on your health care.
There’s more.
– Because of the Affordable Care Act, young adults under the age of 26 are able to stay on their parent’s health care plans — a provision that’s already helped 6 million young Americans.
– And because of the Affordable Care Act, seniors receive a discount on their prescription drugs — a discount that’s already saved more than 5 million seniors on Medicare about $600 each.
All of this is happening because of the Affordable Care Act.”
Ok, I’ll bite again. Who pays for this litany of new benefits and removal of caps and restrictions? The 250 million Americans who already have “affordable” health insurance? (If we have it, it must be affordable to us, just like our housing.) How does our insurance get more secure and affordable? Yes, we lose on every patient, but make it up in volume.
Perhaps the extra preventive care will lower the overall cost. But I keep hearing new recommendations against screening for things where there is no evidence that intervention is necessary or effective; just presenting people with more to worry about.
I suspect much of the opposition is from people who believe they are being responsible for their own health, and don’t wish to subsidize the deleterious lifestyles of others, including substance abuse issues, aversion to exercise and vegetables, parking in front of the TV every night with 1.75 qts of ice cream. Plus all the totally elective procedures now commonly covered. Other peoples rights to my labor need to end somewhere. I have a high-speed rail system to pay for now.
musical “but make it up in volume”
Yes. Overall a very conservative plan. Created by heritage. Implemented by Romney. Supported by Romney, Newt and a host of others (at one time, until that Obama fella said he liked it.)
The private insurers basically agreed that for the tens of millions of new customers, they would:
– Insurance companies can no longer impose lifetime limits on the amount of care you receive.
– They can no longer discriminate against children with preexisting conditions.
– They can no longer drop your coverage if you get sick.
– They can no longer jack up your premiums without reason.
– They are required to provide free preventive care like check-ups and mammograms — a provision that’s already helped 54 million Americans with private insurance.
– And by this August, nearly 13 million of you will receive a rebate from your insurance company because it spent too much on things like administrative costs and CEO bonuses, and not enough on your health care.
– Because of the Affordable Care Act, young adults under the age of 26 are able to stay on their parent’s health care plans — a provision that’s already helped 6 million young Americans.
re: “Perhaps the extra preventive care will lower the overall cost.”
Really? ya think?
Like PERHAPS if I check the oil in my car, then PERHAPS it will keep my costs down?
Anyway, enjoy your new train!
Thank you Obama and Democrats. I hope you get re-elected otherwise the GOP will do its best to trash it. To those who want to know where the money will come from. It will come from the same place the money comes from to prove free care in our emergency rooms–from the average tax-payer. This expensive type of care could be avoided if people got care in a timely manner, thus saving us all money.
Next time you save a few bucks at WalMart, remember your income taxes are also paying for ER care for its un-insured employees Maybe WalMart isn’t such a bargain afterall.
>Sosepa Tonga recalled the day last year when she went to a free clinic in Menlo Park seeking medical care. A new immigrant, she did not have health care coverage.
Ok, she did not have health care coverage; is it free healthcare coverage what the reporter implies? And if so, are all new immigrants expected to have access to it? including illegal immigrants and immigrants from States that are refusing to join in the Federal mandated implementation of Mr Obama Healthcare Plan?
No Billy I’m not convinced. The auto shop will always tell me I need an oil change, and several other things. The dentist will tell me I need veneers or my teeth are likely to crack and then cost even more. My optometrist tries to sell me new lenses every year because of some imperceptible change, and that I may as well buy them and new frames as well because my company plan covers most of the cost anyway. The medical doctors I see are for health status verifications necessary for licenses and certifications I hold, and those expenses are always out-of-pocket, never covered by insurance, so they never try to up-sell me on prescription orthotics or the latest miracle pills on the premise that “your insurance covers it anyway.” I’d be bankrupt if I bought everything that people try to sell me.
musical: well said.
“I’m not convinced. The auto shop… The dentist … My optometrist … because my company plan covers most of the cost anyway. The medical doctors I see… “
There ya go. Prevention works. The ACA gets more Americans in to benefit from the services.
Americans also get:
– Insurance companies can no longer impose lifetime limits on the amount of care you receive.
– They can no longer discriminate against children with preexisting conditions.
– They can no longer drop your coverage if you get sick.
– They can no longer jack up your premiums without reason.
– They are required to provide free preventive care like check-ups and mammograms — a provision that’s already helped 54 million Americans with private insurance.
– And by this August, nearly 13 million of you will receive a rebate from your insurance company because it spent too much on things like administrative costs and CEO bonuses, and not enough on your health care.
– Because of the Affordable Care Act, young adults under the age of 26 are able to stay on their parent’s health care plans — a provision that’s already helped 6 million young Americans.
How about everyone that thinks this is a bad idea disclose what their medical insurance situation is. I bet the vast majority are insured through their own or a family member’s employer (would also be interesting to know if public or private employer). If so, you are not taking responsibility for your own insurance – you are just one of the lucky ones that hasn’t lost it because the employer has not changed the rules for current and/or retired employees.
I was employed with the same company for 25 years, expecting to be affiliated and insurance qualified through retirement. Through no fault of my own, that is sadly not the case. Because I have familial high blood pressure that takes three different medications to control, I have been considered uninsurable as an individual. I am otherwise healthy, not overweight, and take good care of myself. And yes I am employed, but there are no health benefits. Because I have been uninsured, I have been less likely to seek preventative care or early diagnosis. I am very happy Obama care has come about!!! I am happy for everyone who has been a contributing member of our society, but has been put in a very precarious situation. Anyone who feels otherwise has got to be self-centered.
And to those who can only think about the fact that portions will be subsidized by taxes, you really need to look into the millions spent in emergency rooms for what could be taken care of in a doctor’s office…
Those of you who complain that Obamacare is going to lead to tax increases – where were you when the insurance companies were raising our premiums 15% per year on average every year since 2000? http://www.google.com/imgres?q=health+cost+increases+since+2000&um=1&hl=en&safe=active&client=firefox-a&sa=N&rls=org.mozilla:en-US:official&biw=1309&bih=874&tbm=isch&tbnid=I6eMScHXWnk1QM:&imgrefurl=http://monthlyreview.org/2008/02/01/the-health-care-crisis-in-the-united-states&docid=13lN5SQVCAS3jM&imgurl=http://monthlyreview.org/wp-content/uploads/old/2008/080201singer-chart1.jpg&w=424&h=346&ei=3kT7T9LYJ8j3rAHfks2LCQ&zoom=1&iact=hc&vpx=414&vpy=429&dur=179&hovh=203&hovw=249&tx=133&ty=119&sig=104507915474337565356&page=2&tbnh=155&tbnw=191&start=20&ndsp=25&ved=1t:429,r:11,s:20,i:176
Why are annual premium increases OK but tax increases aren’t?
Steve: Because if the govt gets out of my and the insurance companies’ way, they can CHOOSE how much to offer me in coverage, and I can CHOOSE what I want to insure against. Obamacare forces all insurance companies to insure mandates, and me to pay for it!
Notice the 30% increase in rates since Obamacare was passed? Hmm…geee….I wonder what that is about? Wonder how many businesses are planning to dump their employer insurances right now in favor of the penalty..I mean tax???
Perspective:
“Obamacare forces all insurance companies to insure mandates” The insurance companies WANTED that – it gives them 30 million new customers for private insurance, rather than them go on public programs like Medicare or Medicaid. They love the ACA/Obamacare.
You highlight the 30% increase in your rates in the last three years, what about the obscene rate increases before the bill passed?
My rates have been almost flat compared to the big rate increases before Obamacare – not gone up nearly as much as yours since the law. You should try a different company – shop around!
And I got a $442 rebate check in the mail last week because of the ACA/Obamacare. It says they charged me too much and Obamcare forced them to refund me money.
You should definitely shop around!
Oh good grief! Don’t you understand what happened? Assuming you actually got $442 rebate ( the national average is $151), it means
1) You bought your insurance privately, not through an employer, and
2) You CHOSE to buy an insurance that had higher than Obama “demanded” and they are now forced to pay it back to you. Think about it..what was the overhead for? What are you now going to lose? Speediness of approval for procedures or medicines? Customer service based here in the US? There is no free lunch. There is no “pay less and get the same” amount in health care.
You are being bought, just like the insurance companies were bought by being promised “30 million more insured” (not!!). So they gave up the ability to offer low cost insurance in return for the promises of a lot more people…and when they see that in fact they are NOT more profitable as employers dump the insurances in preference for the cheaper penalty (uh..sorry..tax)…it will be interesting indeed.
Congrats on being able to afford a cadillac private plan..Did you see that you will be taxed on cadillac insurances starting in 2018? Oh..and a 3.8% tax starts in 2013 on investments, including any increased value of your home when you sell it? There is no free lunch, baby, just like there is no free health care ( or cheaper, if run by government, unless you want government limiting your choices…)