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ACA Impacts – January 2017

Posted on January 6, 2017 in Ceo Message

ACA Impacts

Senator Patty Murray and her staff are working hard to preserve the gains that the ACA (Obamacare) has brought to our patients. Recently, she reached out to ask us to share some stories about those patients.

Statistics are great…and there are a lot of them.  Yakima County has benefited disproportionately from the ACA. We lead the state in terms of the proportion of people who gained coverage through the Exchange (Washington Health Plan Finder) at 47% (100,974 enrollees).  We also lead the state in the proportion who gained Medicaid coverage (Apple Health) as a result of the expansion, with more than 30,000 newly covered, and another 3,600 enrolling in Qualified Health Plans.

Stories help to paint the real picture, and here are some that our staff shared with Senator Murray:

John is a 34 year old, married type I diabetic, who also suffers from high blood pressure, and asthma.  He’s been a patient at our health clinic for 10 years.  He’s got a steady job at a taco stand, but it doesn’t come with insurance, and he couldn’t afford it.  Our staff did all they could to help John such as discounting fees and providing free/sample medications when they were available. But that couldn’t keep John’s diabetes under control.  As a result, he started to developing chronic complications, and frequently would need to go to the ER for acute high blood sugar with complications.  The natural response of John’s primary care provider was to send him to a specialist.  But he couldn’t afford that either, so he never went.  That’s probably OK.  All he really needed was the means to follow the recommendations of his PCP, and when the ACA took effect, he found it.  Turns out he made just a bit too much to qualify for Medicaid Expansion, but we is able to afford (with subsidies) a plan on the Exchange.  Now that he can afford his meds regularly, his diabetes and other conditions are controlled, he feels much better and has not been to ER.  Hopefully his chronic complications can be reversed or staved off.

Our health center also partners with and supports a free clinic.  It operates at our site, and our doctors volunteer to see their patients.  Prior to the ACA, this could be rewarding but frustrating experience.  The clinic could not see all that needed help.  Many needing help had chronic conditions and needed a PCP, or had a diagnosis that required the attention of a specialist.  Getting them to the right care, with no money and no insurance, was challenging.  One of our NPs remembers losing one of those patients to throat cancer. It took so long to come up with the $125 needed to see the specialist that his disease was too advanced to do anything about it.  Today, demand for the free clinic has decreased…an outcome that they applaud…and we are able to help those in need to find coverage so that they can afford the services that the doctor recommends.

We know that coverage and access are problems aren’t solved yet, but let’s hope that we can continue to move toward that goal, not shy away from it.

Mike Maples, CEO