Obamacare Means New Challenges for California’s Safety Net Providers

Natividad Medical Center is a public hospital in Salinas. It's part of the system of safety net institutions that serve Californians with nowhere else to go. Even as health reform is implemented, millions of Californians will remain uninsured. (Lisa Morehouse/KQED)

Natividad Medical Center is a public hospital in Salinas. It’s part of the system of safety net institutions that serve Californians with nowhere else to go. Even as health reform is implemented, millions of Californians will remain uninsured. (Lisa Morehouse/KQED)

By Lisa Morehouse

California leads the nation in the number of people getting insurance through the Affordable Care Act. But now that the final deadline has come and gone on Tuesday, millions are still left uninsured. These people will still turn to community clinics and public hospitals for care — they are the safety net institutions that serve Californians with nowhere else to go. But as the ACA is implemented, those institutions are facing changes.

One such place is Centro Medico. It’s tucked away in a corner of a shopping center in Cathedral City, a predominantly Latino bedroom community sandwiched between the resort towns of Palm Springs and Rancho Mirage. Here is where many hospitality workers who serve the neighboring resorts live.

Centro Medico’s manager, Daisy Morfin, sees a lot of pent-up need for medical care. Since enrollment in the Affordable Care Act started last fall, she says the clinic is getting up to 10 new patients a day.

Many are people who have qualified for health insurance for the first time in years — or ever. Continue reading

Prisons Are Main Source of California’s Psychiatric Housing

(Photo/Gregory D. Cook)

(Photo/Gregory D. Cook)

By Hannah Guzik, HealthyCal

California’s jails and prisons hold far more people with severe psychiatric illnesses than state hospitals, according to a recent report from the Treatment Advocacy Center and the National Sheriffs’ Association.

“For a state with 38 million people — 1 in every 8 Americans lives in California — there are almost no public psychiatric beds available for individuals with serious mental illness,” the report says.

Four state hospitals — Metropolitan, Patton, Napa, and Atascadero — have just over 4,500 beds, but 88 percent of them are reserved for mentally ill individuals who have been charged with crimes, according to the report. Another state hospital at Coalinga is used almost exclusively for sexually violent predators. Continue reading

Two Different Reactions to Obamacare

The 2014 enrollment period for the Affordable Care Act closes tonight. For some people the new health law is a godsend. Others barely noticed its existence.

Donna Zeuli and her husband lost their insurance when he retired two years ago. Private insurers denied them both because of pre-existing conditions and the COBRA plan offered through his union was too expensive. So they decided to take their chances and wait for Obamacare to take effect.

Then, last fall, Zeuli had a mini stroke at her home in Magalia, Calif., in the foothills of Chico, and was rushed to the ER.

“You can’t believe the angst I had about not having insurance,” says Zeuli, 55. “The only thing I could think about was how much is this going to cost me. Do the minimum. But make sure I’m not gonna die.” Continue reading

Could What You Believe About Your Food Affect Your Metabolism?

(via NPR)

In a study, people were given either a “healthy” milkshake or an “indulgent” one. But both milkshakes were the same. (via NPR)

By Alix Spiegel, NPR

Ever spend a lot of time looking at a food label, weighing — is this food good for me? Bad for me?

Here’s the thing you probably haven’t stopped to consider: how the label itself is affecting you.

Sounds crazy, but if participants believed the milkshake was “indulgent,” they thought they’d eaten more, and their digestion was affected. 
“Labels are not just labels; they evoke a set of beliefs,” says Alia Crum, a clinical psychologist who does research at the Columbia Business School in New York.

A couple of years ago, Crum found herself considering what seems like a pretty strange question. She wanted to know whether the information conveyed by a nutritional label could physically change what happens to you — “whether these labels get under the skin literally,” she says, “and actually affect the body’s physiological processing of the nutrients that are consumed.”

As a student, Crum had spent years studying the placebo effect — how a sugar pill can physically alter a body if the person taking the pill believes it will. She figured food labels might work the same way. So she came up with an experiment. Continue reading

Deadline Tuesday: Final Days to Enroll for 2014 Health Insurance

(Getty Images)

(Getty Images)

Time’s up.

After various extensions, the deadline to finish signing up for a health plan under the Affordable Care Act is here. People have until 11:59 p.m. Tuesday to complete their applications.

If you don’t have insurance you may have to pay a penalty on your taxes next year — as much as 1 percent of income.

Dana Howard from the state marketplace Covered California says the deadline is real. There will be no more grace periods for people who encounter long lines or technical difficulties on the website. There will be no special dispensation this time for people who wait until the last minute.

“We’re not making up a new policy for people who have not taken this seriously,” Howard said. “This is your health. This is a new law.” Continue reading

Despite Obamacare, Big Gap in Substance Abuse Treatment

Jessica Schabel, 19, is under treatment at the Impact Drug and Alcohol Treatment Center in Pasadena for heroin and methamphetamine addiction. Her insurance benefits only allowed for 30 days, but the facility paid for her to stay an additional 30 days to continue treatment. (Heidi de Marco/KHN)

Jessica Schabel, 19, is under treatment at the Impact Drug and Alcohol Treatment Center in Pasadena for heroin and methamphetamine addiction. Her insurance benefits only allowed for 30 days, but the facility paid for her to stay an additional 30 days to continue treatment. (Heidi de Marco/KHN)

By Anna Gorman, Kaiser Health News

The nation’s health law has promised sweeping changes to help millions of people with drug or alcohol addiction get treatment. Many unable to afford services in the past now can receive them without first landing in jail or an emergency room, health officials say.

An old law bars many residential drug treatment centers from billing Medicaid.
“There is no illness that will be more favorably affected [by the Affordable Care Act] than substance abuse,” said A. Thomas McLellan, former U.S. deputy drug czar who now heads Treatment Research Institute in Philadelphia. “This is the beginning of substance abuse disorders being part of mainstream health care.”

The law requires that substance abuse treatment be offered to people newly insured through the insurance exchanges or Medicaid, the government health plan for the poor and disabled.

But serious impediments remain to widespread access, including a shortage of substance abuse providers and available beds nationwide, say treatment experts and government officials. Continue reading

Analysis: Nearly 500,000 Uninsured Now Covered on California Exchange

Certified specialist helps a consumer apply to Covered California at a free enrollment fair at Pasadena City College. (David McNew/Getty Images)

Certified specialist helps a consumer apply to Covered California at a free enrollment fair at Pasadena City College. (David McNew/Getty Images)

By David Gorn, California Healthline

No one knows yet exactly how many of the 1.2 million people enrolled so far in Covered California were previously uninsured — but one person has a pretty good guess.

“Over the next few years at the exchange, we expect to see much higher numbers of the previously uninsured.” 

Ken Jacobs, chair of the Labor Center at UC-Berkeley, projects about 39 percent of enrollees were previously uninsured, or roughly 468,000 people. (With Thursday’s announcement of an additional 70,000 people enrolled on Covered California during the grace period, it’s reasonable that the number of previously-insured-now-covered will rise.)

That means it’s likely that 61 percent of Covered California enrollees already had health insurance.

“One reason is you have to look at who was expected to enroll in the exchange, and there were two large groups,” Jacobs said. “One of those groups is the people in the individual market.” Continue reading

How The Stigma of HIV Can Linger and Keep People from Care

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Lenworth Poyser (left) works with a colleague at Children’s Hospital Los Angeles. Poyser is a health educator for a project focused on reaching young, gay men of color who are HIV-positive. (Susan Valot/KQED)

Editor’s Note: Lack of health insurance isn’t the only barrier to getting medical care. The stigma and fear around HIV can keep people from seeking help. As part of our ongoing health series Vital Signs, we hear from Lenworth Poyser. He was homeless and living with HIV. Now, Poyser helps young HIV-positive men support each other through a group at Children’s Hospital Los Angeles. 

By Lenworth Poyser

When I first came out, when I was still in Texas, I left my mother’s house. At the time I was 18. What she was basically saying is: You can be in this house, just don’t be gay in this house. And I couldn’t do it. So, I threw my clothes into a trash bag and got out.

My sister had invited me to move out to L.A., move out to L.A. And, when HIV hit, I was like, “Oh, life is too short.” So, I decided to just do it. Continue reading

Prescription: Take New Medicare Data With A Dose of Caution

The data details payments to individual doctors, but experts warn against drawing sweeping conclusions from the numbers.(Getty Images)

The data details payments to individual doctors, but experts warn against drawing sweeping conclusions from the numbers.   (Getty Images)

By Mark Memmott, NPR

The headlines about one of Wednesday’s big stories — the release of data from 2012 about Medicare payment to doctors around the nation — are certainly serious sounding:

— “Sliver of Medicare Doctors Get Big Share of Payouts.” (The New York Times)

— “Small Slice of Doctors Account for Big Chunk of Medicare Costs.” (The Wall Street Journal)

— “Release of Medicare doctor payments shows some huge payouts.” (Los Angeles Times)

Here’s how The Associated Press sums up the news: Continue reading

In San Francisco, Brain Surgeons Explore Their Practice Through Art

Neurosurgeon Katherine Ko stands next to her painting "Craniotomy in G Sharp," a depiction of her drilling a skull in preparation for brain surgery. "It's kind of a self portrait," she says. (April Dembosky/KQED)

Neurosurgeon Katherine Ko stands next to her painting “Craniotomy in G Sharp,” a depiction of her drilling a skull in preparation for brain surgery. “It’s kind of a self portrait,” she says. (April Dembosky/KQED)

SAN FRANCISCO — Most of the Moscone Center exhibit hall is full of looming medical machines: brain scanners and brain mappers. Men in suits wait for the wandering neurosurgeon to pass by so they can pounce with their pitch for the latest, greatest technology that will change brain surgery forever.

“Patterns repeat themselves over and over in nature. We see that in our work and in anatomy.” 

But back at exhibit booth 630, it’s a different scene. An art show. Paintings and photographs depict abstract interpretations by neurosurgeons of their work, portraits of neurosurgery patients and natural landscapes that offer a striking resemblance to the human brain.

“Music, art, the visual, the senses — matches and melds with medicine,” says Dr. Katherine Ko, a neurosurgeon from New York who curated the show. “We like to see that left brain, right brain cross over. It’s a respite where you don’t have to concentrate. You can just let your eyes roam.” Continue reading