L.A. County offers $61-million health plan for those still uninsured

The $61-million My Health L.A. will assign uninsured patients to a "medical home" at one of about 150 clinics

Los Angeles County will provide access to a primary care doctor for nearly 150,000 uninsured Los Angeles County residents, including many who are ineligible for Obamacare coverage because they lack legal immigration status.

My Health L.A., as the $61-million program for the uninsured is called, will assign uninsured patients to a "medical home" at one of around 150 community clinics, said Dr. Mitchell Katz, director of the county's Department of Health Services. 

Unlike an earlier county program it replaces, which provided care at community clinics on an episodic, per visit basis, My Health L.A. will go a step further -- paying the clinics a set amount every month to coordinate a patient's overall care.

"Once the patient enrolls, the clinic's responsibility is to be their provider and to take care of their wellness in ways that will reduce ER use and will help the person be healthier," Katz said. "It's a broadened scope of work."

The new set-up will also require patients to stick with a single primary care provider once they have signed up, in theory reducing the ability of "frequent flyers" to rack up repetitive medical visits in county facilities.

"They'll have a card, they'll know where to go if they get acutely ill and need an urgent care visit," Katz said. "We will not pay if they go elsewhere...and everyone will know which clinic the person is in."

More than 10,000 Los Angeles residents already had been enrolled in the program as of Tuesday of last week, county officials said.

"We're looking at L.A .County being one of the first counties to provide universal coverage to everyone, regardless of immigration status," said Jim Mangia, CEO of St. John’s Well Child and Family Center, one of the clinic systems participating in the effort. "It expands on the promise of Obamacare."

But Daniel Zingale, senior vice president of the California Endowment, said his organization would continue pushing for an interconnected, statewide solution, possibly coordinated through Medi-Cal.

Advocates in Los Angeles County pushed in March for a broader My Health L.A. program. In the end, county supervisors voted 4-1 to authorize what amounted to a cost of living increase over what had been allotted for the earlier program.

Supervisor Michael D. Antonovich was the dissenting vote.

"This is yet another example of how the County must shoulder the burden for the Federal Government -- which has failed to secure the border and continues to incentivize illegal immigration," he said, in a statement issued by his office on Sept. 23.

Estimates have suggested that as many as 3 million to 4 million people statewide, and around 1 million in Los Angeles County, will remain without healthcare coverage after Affordable Care Act reforms are fully rolled out.

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