Health Lead Story West Edition

Thousands enroll in new health insurance program

LOS ANGELES – (CBM) – As far as Ronail “Stretch” Shelton knows, his health is great.

Strong, athletic and fit, the Los Angeles-based personal trainer, is one of hundreds of thousands of Californians of all races who renewed or began Medi-Cal coverage this year. Despite having a clean bill of health, Shelton, 31, who is African American, says he understands why he needs reliable health coverage.

“If something were to happen suddenly, I might not be able to afford to pay for it,” said Shelton, who is self-employed.

According to recent reports, Shelton is one of nearly 780,000 Californians who either enrolled or re‐enrolled in Medi-Cal, the Golden State’s safety-net health insurance program, during its second open enrollment period from Nov. 15, 2014 through to Jan. 31.

Although Covered California, the state’s health exchange, has not yet reported how many black Californians are in that number, African Americans accounted for six percent, or 114,000, of the 1.9 million people who registered for Medi-Cal during the initial enrollment period of October 2013 to April 2014.

Medi-Cal provides low-cost health coverage for children and adults with low to no income and resources. Under the program — administered by the California Department of Health Care Services (DHCS) — qualified applicants receive free or low-cost health coverage. Eligibility for free Medi-Cal is determined by household income and family size, among other requirements.

Each year, the U.S. Department of Health and Human Services sets guidelines that determine whether families or individuals qualify for certain federal assistance programs based on their income. In 2015, according to that measure, a family of four must earn less than $23,550 to fall below the poverty level. For an individual, that number is $11,490, and $15,510 for a family of two.

However, the state of California has its own index for determining who qualifies for Medi-Cal. According to DHCS, a family of four must earn less than $32,913 to fall below the poverty level. For an individual, that number is $16,105, and $21,708 for a family of two.

Toni Newman, development and administration coordinator with To Help Everyone (T.H.E.) Health and Wellness Centers in Los Angeles, said African Americans can get low-cost or no-cost health insurance with Medi‐Cal and other plans offered through the Affordable Care Act (ACA), commonly known as “Obamacare.”

“Health plans offered by Medi-Cal include benefits known as ‘essential health benefits,’” said Newman, who represents one of the Southside Coalition’s community health groups.

Those health benefits include dental services, emergency services,hospitalization, outpatient services, prescription drugs, laboratory services, and children’s services such as oral and vision care. Maternity and newborn care, preventive and wellness services, chronic disease management, mental health services, substance use disorder services, and other rehabilitative devices and programs such as physical and occupational therapy also are covered by Medi-Cal insurance.

Newman said T.H.E.’s doctors and nurses are accustomed to dealing with health issues associated with the disadvantaged communities it serves.

“Sixty percent of T.H.E. patients use Medi-Cal and most of that population are minorities,” she said. “A lot of African Americans suffer from high blood pressure and diabetes.”

At each of the centers, T.H.E. offers medical services for men, women, children, and teens, as well as public health and preventive education services.

Although enrollment for Medi-Cal jumped dramatically during Covered California’s open enrollment period through Feb. 15, enrollment or renewal for Medi‐Cal is available all year long to those who qualify, officials said, as opposed to the private health insurance plans offered through Covered California as part of the ACA.

Shelton, the L.A.-based personal trainer, said getting through the renewal process was smooth even though he experienced a hiccup early on.

“I didn’t get the paperwork,” he said. “So they assigned me someone that helped me get it done.”

For information on how to enroll by mail, by Internet or in person, call (800) 300-1506 or visit www.coveredca.org.