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Pasadena Public Health Department

  • Health Care Reform

    In 2010, a federal law known as the Patient Protection & Affordable Care Act (ACA, and more popularly known as "Obamacare") came into effect to change how people throughout the United States get health insurance, to decrease the number who do not have health insurance and to improve the quality of health care while decreasing overall costs. Since 2010, the Pasadena Public Health Department (PPHD), in conjunction with community partners, has taken many steps to prepare for the ACA implementation date of January 1, 2014.  By this date, every U.S. citizen and legal resident must have health insurance.  For more on the Affordable Care Act, watch the following video developed by the Kaiser Family Foundation:

     

     New! Read page 2 of Pasadena Healthy Times for updates on Covered California's open Enrollment, starting on November 15, 2014!

    The following summarizes the changes to health care that have already occurred and will occur as a result of the ACA:

     What has already changed before 2014? 

    • Health insurance must include check-ups and preventive care for free
    • Young adults can stay on their parents' health insurance plan until 26 years old
    • Insurance companies cannot cancel current health insurance if an individual is sick
    • Insurance companies cannot deny care for children because they are sick now or have been sick in the past
    • Insurance companies must spend 80% of your money on health care or give you money back

    What will change January 1, 2014? 

    • There will be new ways to get free or low-cost health insurance
    • If an individual does not have health insurance, a penalty will be imposed
    • Insurance companies cannot deny anyone health care because they are sick or have a pre-existing condition
    • Insurance companies cannot charge an individual more money or limit how much they'll pay because you are sick
    • Former youth in foster care who had Medi-Cal at age 18 will be eligible for Medi-Cal until age 26

     If you already have health insurance, here is how health reform can impact you: 

    • Medi-Cal: If you have Medi-Cal, you keep your health insurance.  Find out more from the Los Angeles County Department of Public Social Services (DPSS).
    • Healthy Way LA (HWLA): If you have HWLA, you will be transitioned into Medi-Cal on January 1, 2014.  You will receive information in the mail regarding the change.  Read more from the Los Angeles County Department of Health Services.
    • Medicare: If you have Medicare, you keep your health insurance.  The ACA may lower the cost of your medicine, and you will not have to pay for preventive care, such as vaccines, flu shots, and wellness visits.  Learn more at http://www.medicare.gov.
    • Employer-based: If you currently receive insurance through your job, you keep your insurance.  To find out more, contact your health plan or employer.
    • You can continue to purchase your own health insurance.  Starting October 1, 2013, you can shop for lower cost health insurance through Covered California.  For more information, visit http://www.coveredca.com/.
    • Healthy Families: If your children were enrolled in Healthy Families, they were transitioned into Medi-Cal starting January 1, 2013. If you are still receiving information on Healthy Families or have questions on the transition and your child's benefits, visit the Pasadena Public Health Department Children's Health Insurance Outreach Program.

     

    Changes to Medi-Cal

    If you do not have health insurance, starting January 1, 2014 you may qualify for Medi-Cal, California's Medicaid Program.  Medi-Cal eligibility will expand to cover the following groups:

    • Legal permanent residents and citizens ages 19-64 with incomes up to 133% of Federal Poverty Level (FPL, which is $15,252 for an individual)
    • Adults without dependent children living at home up to 133% of FPL

    The following populations will continue to be eligible for Medi-Cal:

    • Children (ages 0-19) with household incomes up to 250% FPL
    • Parents with dependent children  up to 100% of FPL
    • Pregnant women up to 200% of FPL
    • Seniors up to 133% of FPL
    • People with disabilities up to 133% of FPL

    To enroll in Medi-Cal or find out if you qualify, call the Pasadena Public Health Department at (626) 744-6086.  There is no fee to apply.

    Behavioral Health Coverage under Medi-Cal has expanded and mental health services have been identified as essential health benefits, and therefore be more accessible.

    • Mental health services for the severely and chronically mentally ill will be available through Los Angeles County Department of Mental Health
    • Psychological services for less severe disorders will be provided through the Medi-Cal Managed Care Plans and their provider networks
    • Expanded  substance use disorder treatment services will be available to all Medi-Cal enrollees

     

    Covered California

    Covered CA is the State's new health insurance marketplace, or "Exchange".  Covered CA has two separate markets, one for individuals and families, and another for small businesses (also known as SHOP, Small business Health Options Program).  This virtual health insurance marketplace will provide educational tools, price calculators, and other comparative information that will help individuals make informed decisions when purchasing health insurance plans.  Covered CA insurance plans will cover the following 10 essential health benefits:

    • Ambulatory patient services
    • Emergency services
    • Hospitalization
    • Maternity and newborn care
    • Mental health and substance use disorder services
    • Prescription drugs
    • Rehabilitative and habilitative services and devices
    • Laboratory services
    • Preventive and wellness services and chronic disease support/management
    • Pediatric services, including oral and vision care (note: oral and vision care are not included for adults)

    Only U.S. citizens and legal permanent residents can purchase health insurance through Covered CA.  Those with incomes between 100% - 400% of FPL may be eligible for federal subsidies.  Enrollment into Covered CA is available between October 1, 2013 and March 31, 2014.  To speak with someone regarding Covered CA, call our partner, Young & Healthy at (626) 795-5166.  There is no fee to apply and no fee for application assistance.

     

     

    Other Options

    Even with implementation of the ACA, it is anticipated that individuals will continue to be uninsured.  There are options for these individuals to seek health care.  Download this PDF, developed by Insure the Uninsured Project to read about various County and State programs.  Additionally, county and community health clinics are currently available to those who cannot receive health insurance due to citizenship, residency, age, or other reasons.  Visit http://www.ladhs.org/wps/portal/clinicsearch to find a clinic near you.

     

     

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