Congressman Raul Ruiz speaks at the 2013 Coachella Valley Economic Partnership Economic Summit on Friday. / Omar Ornelas, The Desert Sun
PALM DESERT — Health is closely tied to a community’s vibrancy and the collaborative efforts of its members, and the Affordable Care Act aims to bolster that well-being, health care speakers stressed at the 2013 Coachella Valley Economic Partnership Economic Summit on Friday.
“Health is really about and completely interdependent with this community,” said Dr. Benjamin Chu, group president for Kaiser Permanente Southern California and the keynote speaker at the “Healthy Progress”-themed summit. “I think it’s exactly the right direction.”
PHOTOS: CVEP Summit 2013
Chu spoke on the ACA and how it will impact hospitals, providers and community members, repeating the mantra of “health care for all, paid for by all.”
The law aims to bring into coverage, and out of the emergency room, the estimated 6 million uninsured Californians — and millions more nationally — through an individual mandate, state exchanges that will offer federal subsidies to those living between 138 and 400 percent of the federal poverty level, and an expansion of the Medi-Cal welfare program.
“There’s so much uncertainty and there’s so much complexity that it’s hard to know exactly how it’s going to turn out for all of us,” Chu said, adding that he believes it will turn out all right for everyone.
“It’s going to be important to let things play out,” he added.
“With the launch of the Affordable Care Act, we are now in the midst of one of the most dramatic changes in health care in decades,” Carolyn Caldwell, CEO of Desert Regional Medical Center, said at the summit.
With these big changes comes confusion. Just 15 percent of voters considered themselves to be “very knowledgeable” on the law, according to an August Field Poll.
Chu believes the ACA will really take about three years to reach full implementation. Covered California, the state’s new insurance marketplace, opened for enrollment Oct. 1, and the plans will go into effect Jan. 1, along with the Medi-Cal expansion. But the individual mandate, which makes coverage mandatory for almost everyone, will include small penalties in its first year that will gradually increase over the next three years and could even be delayed.
Hospitals and providers bought into reform early on and advocated for the changes and remain optimistic about getting everyone covered and moving them into primary care, a “more sensible” method of treatment, he said. But some are wary because of reimbursement issues. Payment systems are being reformed under the law, and everyone’s a little bit worried about whether they’re going to lose out. The hospital industry agreed to millions of dollars in reimbursement cuts from Medicare to bring all the newly insured into coverage.
Other industries, including some medical device manufacturers and insurance companies that are carrying some of the hefty price tag for the ACA through taxes, are concerned about their their bottom line.
“There’s a lot of behavior out there that could undermine the overall financing of the ACA,” Chu said. “It’s health care for all paid for by all until it comes to my part of the cost.”
Some people are also concerned about their insurance plans being canceled, after reports this week of millions losing their current coverage. Plans that were not grandfathered in before March 2010 are experiencing changes or cancellations, but many of them did not meet the minimum essential health benefits mandated by the law, Chu said. Essential health benefits covered by the ACA include mental health and substance abuse treatment and prevention and wellness services, among others.
There are also alternatives now including the exchange, and “in most of these instances,” new plans will have even better coverage, he said. These backup plans will help to relieve some of the job lock that currently goes on where people feel forced to stay at their job to keep their health insurance.
In addition, the halt to the longstanding insurance practices of denying those with preexisting conditions and placing lifetime limits on health care spending will “level the playing field” of health care, he said.
Overall, the reform will be a step in the right direction if strong community partnerships work together, Chu said.
Rep. Raul Ruiz, who attended the summit, also said the ACA was moving things in the right direction but was “imperfect,” particularly because of the primary care shortage that could be worsened by the many newly insured. He stressed the work of his program Future Physician Leaders, CVEP and other valley organizations aiming to train homegrown doctors in easing that problem.
Chu pointed to technology and tele-health for addressing what will be in the short term a “squeeze” on primary care providers, he said. He added that growing other care forms and looking into expanding the scope of practice for other medical providers like nurses could ease the problem.
John F. Kennedy Memorial Hospital in Indio and Desert Regional announced a new campaign Friday, called Path to Health, focused on ACA outreach and education — to try to answer all the questions from both the uninsured and currently insured about what the law will mean for them, JFK CEO Gary Honts said.
Tricia Gehrlein, regional director of the Clinton Health Matters Initiative in the Coachella Valley, said the message resonated with her after the initiative’s health work with various community groups.
“Our new theme is we’re all in this together,” Gehrlein said. “This is a community health priority.”
Reporter Victoria Pelham can be reached at Victoria.Pelham@thedesertsun.com.