Health reform hits the streets - U-T San Diego

For three years, the Affordable Care Act has been a bewildering collection of rules, regulations and reforms, but now, as its main provisions draw closer, San Diego County residents are getting a chance to meet Obamacare in the flesh.

At street fairs, farmers markets and even nail salons, experts are being dispatched to explain the state’s new heath exchange and how it will work when it opens on Oct. 1. On Saturday, Mao Nieto of the La Maestra Community Health Center was among the first to wear the mantle of health reform, sitting behind a table draped with a Covered California banner during a health fair at the George Stevens Senior Center in Encanto.

Covered California is the name of the state’s new health exchange, which will be where uninsured Californians can buy health insurance policies that are subsidized based on household income. Health reform requires nearly every American to buy health insurance starting Jan. 1, if they aren’t already covered by an employer-sponsored plan or a government program like Medicare or Medi-Cal.

At midday Saturday, Jose Aguilar of Encanto approached Nieto’s table and asked whether his family would qualify for coverage. Speaking in Spanish, the pair discussed the health law and Nieto directed Aguilar to fill out a contact card so that an exchange representative could call with more information.

A custodian who said he had been laid off, Aguilar said he would consider buying health insurance if it was not too expensive.

“Maybe, if it’s below like $50 a month,” he said.

This type of exchange between Nieto and Aguilar is not an example of simple kindhearted charity. The massive outreach effort now starting in California, and most of the nation, is about survival of the Affordable Care Act itself. Millions must enroll for this health care experiment to work.

“If people don’t enroll, then there is no Affordable Care Act. I think its success completely hinges on getting people through the door and signing them up,” said Larry Levitt, senior vice president of special initiatives for the Kaiser Family Foundation.

Gearing up

The federal government will spend about $684 million on publicity, marketing and advertising of the health reform bill and about $174 million of that amount is earmarked for California, according to The Associated Press.

All of that spending has frustrated conservatives in Congress who are opposed to the new law. They have vowed to cut off funding and even shut down the government if necessary. House Speaker John Boehner said on a recent Sunday TV news program that the health bill is “bad for America” and that “We’re going to do everything we can to make sure that it never happens.”

Meanwhile, local promotion efforts are ramping up.

Dana Howard, a spokesman for Covered California, said the exchange has spent $43 million to hire about 2,000 outreach workers statewide to spread the message. Three organizations serving San Diego County have received grants totaling $2.25 million. An additional 19 statewide or multicounty groups that will also do some of their work in the region have gotten a total of $14 million.