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A Homegrown Health-Care Success Story


By Letisia Marquez '94

Published Oct 1, 2012 8:00 AM

Recently divorced and unemployed, Ruthann Berman walked into a Ventura County Health Care Agency office with another huge worry on her mind — just two weeks prior, a doctor had found a small, painful lump on her left breast.

Berman, 42, an unemployed gas station attendant from Oxnard, hasn’t been able to find a permanent job since 2009.

Inside the office, she applied for something that she long thought was out of reach: health coverage.

She is just one of more than 11,000 Ventura County residents enrolled in the Low Income Health Program (LIHP), a county-based health-care coverage program that’s part of California’s early efforts to enroll more people in the Affordable Care Act’s Medicaid expansion. Essential to the program is the UCLA Center for Health Policy Research, which is tracking LIHP to evaluate how successful it is in reaching, enrolling and retaining patients like Berman. The center’s efforts are funded by the state and the Blue Shield of California Foundation.

The center found that more than 413,000 low-income residents — an impressive 22 percent of those whose incomes make them eligible for either the Medi-Cal Expansion or the Health Benefits Exchange — have obtained health insurance since July 1, 2011, thanks to LIHP.

“There is a tremendous drive now to insure more people, but the key is also to keep them enrolled,” says Gerald Kominski, the center’s director and a UCLA professor of health policy and management. “LIHP is a laboratory for providing coverage and care to low-income populations, and the center is playing an important role in helping counties understand how their outreach and enrollment efforts compare to other counties and learn from new or innovative approaches.”

In 2009, an estimated 7 million people under 65 were uninsured in California for all or part of a year, placing a huge and costly burden on emergency rooms, community clinics and, ultimately, Golden State employers and taxpayers. Numerous studies have found that providing primary and preventive care can reduce far more costly emergency or inpatient care down the line.

In Ventura County, where the LIHP is named the Access Coverage Enrollment Program, or “ACE ,” health officials are using every tool at their disposal to reach people — and ensure they stay enrolled.

At health fairs, homeless programs, housing authority offices, swap meets, consulates and other locations, health officials are letting people know that they may qualify for health coverage.

California counties can set different income levels for who can qualify for LIHP up to twice the federal poverty level. In Ventura County, the cutoff is 200 percent of the poverty level for a family of four, or $46,000.

“The ACE program has enabled many people — some for the first time in years — to get lab tests done, fill prescriptions and return for follow- up visits, which, in the long run, will reduce health-care costs,” notes Robert Gonzalez ’73, M.D. ’77, director of the Ventura County Health Care Agency. The need among employed people for insurance was evident at the Ventura County enrollment center. Oxnard resident Judi Martin, 57, works part-time as a bank teller because she hasn’t been able to get full-time work and, as a result, has been without health insurance.

She’s now enrolled in ACE , and in March the program helped Martin seek treatment at the Ventura County Medical Center for a set of painful symptoms that turned out to be caused by a kidney stone. And without ACE , Louis Mitchell, 63, of Newbury Park might not have seen the doctor who, in 2011, discovered kidney cancer and removed half of his kidney on Halloween night.

And Ruthann Berman? She enrolled in ACE and got a mammogram, which showed that she does not have breast cancer. “I’m glad I finally did it,” she says.