Obamacare: Slow start to first day of signups at County-USC hospital

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Medi-Cal patient Elizabeth Martinez, and her 2-year-old son Maximiliano, wait to see a doctor in the emergency room of L.A. County-USC Medical Center in Los Angeles. This is the first day for signups for insurance coverage through the Affordable Care Act -- also known as Obamacare. Martinez said that she knew very little about the Affordable Care Act. (Genaro Molina / Los Angeles Times)

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Patient resource worker Jose Amparo Garcia, right, checks in Carlos Revelo, 60, who was applying for the Ability to Pay plan at L.A. County-USC Medical Center. Revelo, who is unemployed and has no health insurance, has done very little research on the Affordable Care Act. (Genaro Molina / Los Angeles Times)

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John Wieger, who recently moved from Arkansas to Los Angeles, waits outside the JWCH Institute in Los Angeles’ skid row for help with a knee injury. (Al Seib / Los Angeles Times)

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Lionel Mathis, shown outside the JWCH Institute in Los Angeles’ skid row, talks about Obamacare on the opening day of enrollment for insurance under the federal health program. (Al Seib / Los Angeles Times)

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Marisela Garcia holds her 2-month-old son, Abraham Angulo, as she fills out paperwork with her other children Victor Garcia, 11, and 3-year-old Miley Garcia at Molina Health Clinic in Fontana. (Irfan Khan / Los Angeles Times)

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Nurse Marisol Vasquez measures the height of 11-year-old Victor Garcia at Molina Health Clinic. Garcia’s mother came into the clinic in Fontana looking to purchase insurance through the exchanges, because her insurance is expiring at the end of November. (Irfan Khan / Los Angeles Times)

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Annette Diaz holds her daughter Kayla Valenzuela, 3, with her son Johnnie Valenzuela, 5 months, sleeping while they seek help in the Health Benefits Resource Center at St. Francis Medical Center in Lynwood. (Mark Boster / Los Angeles Times)

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Annette Diaz holds her daughter Kayla Valenzuela, 3, while they seek help in the Health Benefits Resource Center at St. Francis Medical Center in Lynwood. Diaz and her family were seeking help with the CalFresh program and also received counseling about the Affordable Care Act and insurance exchange. (Mark Boster / Los Angeles Times)

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Maria Zavala, an Outreach Benefits Specialist with St. Francis Medical Center in Lynwood, holds a flyer announcing an upcoming healthcare event providing details to the public about the Affordable Care Act. (Mark Boster / Los Angeles Times)

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Rosana Herrera, left, operations coordinator at the Health Benefits Resource Center at St. Francis Medical Center in Lynwood, offers daily help and counsel on the Affordable Care Act and insurance exchange issues to confused patients and clients. (Mark Boster / Los Angeles Times)

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A Zumba exercise dancer performs during the launch of Affordable California, the state’s Affordable Care Act marketplace, at Union Station in downtown Los Angeles. (Luis Sinco / Los Angeles Times)

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Covered California employees Laura Palomares and Naomi Gamez greet visitors to the launch of the state’s Affordable Care Act marketplace during an event at Union Station in downtown Los Angeles. (Luis Sinco / Los Angeles Times)

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Los Angeles Mayor Eric Garcetti congratulates Covered California executive Peter Lee during the launch of the state’s Affordable Care Act marketplace at Union Station in downtown Los Angeles. (Luis Sinco / Los Angeles Times)

By Eryn Brown

Oct. 1, 2013 2:19 PM PT

It was a quiet morning at L.A. County-USC Medical Center on Tuesday, as signups for insurance coverage through the Affordable Care Act -- also known as Obamacare -- got underway.

Hospital staff were mobilizing to sign up patients for expanded Medi-Cal coverage, but at 9:20 a.m., none had yet arrived at the entrance to the ER, where two men chatted at a bench outside and a few patients sat quietly awaiting care inside.

Whether uninsured patients of the county’s largest public hospital sign up for coverage under the provisions of the healthcare law -- or not -- could have a major impact on L.A. County’s health services system, which currently pays for medical care for uninsured patients who cycle through its three public hospitals and network of public clinics.

If people without coverage, who make up 70% of the hospital’s patients, purchase newly affordable insurance or qualify for expanded Medi-Cal benefits, the county expects to spend less on their care.

“More payers coming in is a good thing,” said Michael Wilson, a spokesman for the county’s Department of Health Services.

Proponents of the law are counting on the long enrollment period, which will last six months, even though coverage is due to begin Jan. 1. That means consumers have until March 31 to select a health plan.

Most experts believe that the real test of how well enrollment is working will come in December, just before insurance coverage is supposed to kick in, and again in March, as the enrollment period closes.

Peter Lee, who runs California’s insurance marketplace, Covered California, joked recently that two people in the state would sign up for insurance Tuesday.

“Oct. 1 is just a start … not a magic date,” said Heather Howard, director of the State Health Reform Assistance Network at Princeton University, which is working with states on implementing the healthcare law.

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eryn.brown@latimes.com

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