Editor's note: This is the first in a three-part series about the effects of the Obama administration's health-care reform on Huntington Beach and Fountain Valley health-care providers and their patients.
When Sonia Munguia knocked on the door of the Huntington Beach Community Clinic two years ago, she had no insurance, little money and a set of medical results from Mexico.
The Stanton resident had called clinics around Southern California after discovering a lump in her breast, but they rejected her as being too young for their free-treatment programs. Eventually, she became so desperate that she drove to Tijuana for a mammogram and ultrasound.
Shortly after she returned, a friend pointed her to the Huntington Beach clinic, where she was able to get an appointment within two days. Through a program the clinic runs with the breast cancer awareness nonprofit Susan G. Komen for the Cure, Munguia was able to have another mammogram and ultrasound for $25. The results showed that she had cancer, and staff connected her to an oncologist in the community.
"That clinic, they helped me," said Munguia, who works as a waitress and still returns for annual checkups. "It's a great, great clinic."
In the next half-decade, the clinic may have considerably more patients like Munguia. The Obama administration's long-anticipated health-care reform, which passed in March, aims to expand health insurance to nearly 100% of Americans. Even though the clinic serves uninsured patients, administrator Tracey Gould foresees an influx of visitors largely because, with the government aiming to add 32 million people to insurance rolls, many hospitals expect patients to vastly outnumber doctors.
"I think none of us could even guess what that number could be," Gould said about her clientele in coming years. "But I definitely see an expansion of services at community health centers."
Gould, who took the helm as adminstrator last fall, is used to seeing the waiting room packed. Day after day, her clinic south of the 405 Freeway fills with children and seniors, injured surfers and women seeking prenatal care. Some can pay, some can't, but the clinic's creed is to accept everyone — or, at least, point them to another facility if it can't provide the needed services.
Now, Gould is eagerly awaiting the arrival of construction vehicles in August. The clinic at 8041 Newman Ave., which opened in 1969, has planned a 10-month renovation that will add nine examination rooms, a procedure room, dental services and a call center. New staff will follow to accommodate the added patients. Gould said AltaMed, the Los Angeles-based care system that runs the clinic, planned the changes in anticipation of the government pushing through a massive health-care reform.
That moment arrived this year. On March 23, President Obama signed the Patient Protection and Affordable Care Act, which had passed the House of Representatives two days earlier. A week later, Obama signed another bill to make minor amendments to the first one. The reform imposes many changes on federal funding and insurance company practices, with an overall goal of expanding health care to 95% of Americans.
Many of the bill's changes are scheduled to begin over the next half-decade, but a few kick in this year. By Jan. 1, according to the White House's timeline, companies cannot deny coverage to children with preexisting conditions, deny coverage to people when they get sick or impose lifetime limits on insurance coverage. Americans younger than 26 must also be allowed to stay on their parents' health plans unless they're offered insurance at work.
'You come to us'
The reform has polarized Democrats and Republicans — not a single of the latter supported it in Congress — and has already run into roadblocks in terms of funding. In May, the House of Representatives stripped $24 billion for Medicaid, the government's health program for low-income residents, from an unemployment benefits package.
Local elected officials have denounced the reform, with some high-profile ones, including Fountain Valley Mayor Larry Crandall and Assemblyman Van Tran, even joining a rally May 18 at the Fountain Valley Town Center for the conservative group Revere America.
Many on health care's front lines, though, have a more positive view of the reform — or, at least, a more sympathetic one. Among them is Shirley Dettloff, the former mayor of Huntington Beach and a member of the AltaMed Board of Directors.
Dettloff, who relies on the Duck-A-Thon, a golf tournament and other annual events to help fund the clinic, sees the reform as a moral issue more than a political one.
"If you have a beautiful city like we have, but people are sick and not being treated, they're going to affect all of us," she said. "These are people who work in our hotels, in our retail places of business, in our restaurants, who go to school with us. Without a place for people to go [for treatment], you are affecting an entire population. And to me, that doesn't make sense."
The clinic provides obstetrics, pediatrics, general medicine, gynecology, dental services and more. In a typical year, Dettloff said, the clinic sees about 12,000 patients and conducts about 33,000 patient visits. The majority of the clinic's patients have usually come from the low-income Oak View neighborhood, but the recession, she noted, has resulted in a more varied group.
"If you've lost your job and your health insurance is gone, you come to us," Dettloff said.
A need for space
If the reform — often derisively labeled "ObamaCare" by detractors — ends up bringing a surge in patients to the clinic, it won't be the first time the numbers have increased in recent years.
Since 2000, the number of people enrolled in Medi-Cal, the state's Medicaid program, has increased from 5.3 million to 7.2 million, according to Anthony Cava, a spokesman for the state Department of Health Care Services. Orange County enrollment grew even more drastically, nearly doubling from 218,620 in 2001 to 382,923 this year, according to TerryLynn Fisher, a legislative analyst for the Orange County Social Services Agency.
The economy, Cava said, is the main reason so many people are moving to state-sponsored health plans. And it's a change Gould and Dettloff have noticed in recent years, as their clientele has grown accordingly.
Medicaid doesn't cover all low-income Americans — recipients must fall into one of several eligibility groups — but the reform aims to expand coverage in 2014 to all Americans who make less than 133% of the federal poverty level. In that case, Dettloff said, the new facilities in Huntington Beach should be full on a steady basis.
"That will be a whole new layer," she said. "And that's exactly why we're starting to gear up."
Numberof people receiving Medicaid in Orange County, 2001-present:
Source: Orange County Social Services Agency. Figures are from quarterly reports released in March of each of the above years.
Huntington Beach Community Clinic
Huntington Beach Community Clinic
Address: 8041 Newman Ave., Huntington Beach
Year founded: 1969
Services: General medicine, obstetrics, pediatrics, dentistry and more.
Contact: (714) 500-022