Experts explain the state’s new health-care marketplace.

STORY and PHOTOS By Tam Nguyen, NGUOI VIET

 

GARDEN GROVE, Calif. — Adalhi Montes is 21 and said pain in his leg drove him to find a clinic with a doctor who could diagnose the problem. Five minutes with the physician left him with some answers — and a big medical bill.

Adalhi Montes tells his personal experience to the media.

“I spent my own money and the whole day at clinics,” said Montes, who his not covered by medical insurance. “The money I spent could have been for college.

Montes was one of three people who attended a news conference Friday, sponsored by New America Media, that aimed to answer questions about the new Affordable Care Act, Montes, joined by two medical professionals, helped to explain how the nation’s new health care law, years in the making, will benefit immigrants and the rest of California’s population.

For Montes and his mother, a non-documented resident, the Affordable Care Act will make a world of difference. As of Tuesday, Montes became eligible to enroll in the new online health-insurance marketplace, called Covered California. It will offer 13 health plans covering a standard set of benefits. Open enrollment runs through March 31, 2014, but for those who enroll by Dec. 15, coverage will begin with the new year on Jan. 1, 2014.

Betzabel Estudillo, the health policy coordinator from the California Immigrant Policy Center, said It is important to enroll in the health plan. Children can be enrolled with their parents until age 26, whether they live with their parents or not. Dr. Clayton Chau, an expert in mental health, said those who need mental health care now can have access they couldn’t pay for before without insurance.

Betzabel Estudillo explains the expansion of Medi-Cal.

“It is a huge win because mental care is more expensive than physical, and it helps the community to afford it now that it is part of the plan,” he said. .

Dr. Clayton Chau discusses how non-documented residents can sign up for health care.

The two specialists were able to answer the most asked questions posed to them by the community. The most pressing question: Can non-documented parents sign their U.S.-born child to a health care plan? Yes — and the parent does not need  to provide any information about their immigration status. California has an estimated 7.1 million uninsured residents, and about 2.6 million of them are undocumented.

More questions that were answered in the conference.

The speaker panel (left to right): Adalhi Montes, Betzabel Estudillo, Dr. Clayton Chau

What is the main difference between the current Medi-Cal and the expanded Medi-Cal?

The expanded Medi-Cal will allow childless adults to enroll in the program. It also allows patients to access comprehensive mental health care services same as they do medical health.

Can green-card holders apply for health care if they lived in the country legally for less than five years, whether via  Medi-Cal or the new health care exchange?

Yes.

What are the financial requirements for Medi-Cal eligibility?

It will cover low-income adults making up to 138 percent of the federal poverty level, which translates to $15,850 for an individual or $32,500 for a family of four. Kids will be eligible for Medi-Cal if their family income is up to 250 percent of the federal poverty level, or $59,000 for a family of four.

Qualifying citizens of the U.S. and legal residents can enroll in the expanded Medi-Cal program. Medi-Cal is California’s name for Medicaid, the health insurance program for low-income and disabled people. About 1.4 million people in the state will be eligible to enroll in Medi-Cal, and among them are an estimated 48 percent Latino, 8 percent African American, 7 percent Asian Pacific Islander and 33 percent white.

The federal government will fund the program fully for the first three years, then roll back funding gradually.