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LA County to launch new health care program for uninsured immigrants

Advocates say the next big step in the rollout of the Affordable Care Act is making sure people who are newly insured know how to use their coverage.
Adrian Florido
The Affordable Care Act has covered millions of previously uninsured people. But immigrants in the country illegally are not eligible. A new L.A. county program will provide them free health care.

Immigrants living in the country illegally don’t qualify for benefits under the Affordable Care Act. But beginning Wednesday, they can get free care through a new L.A. County health program that does not require proof of legal residency.

My Health L.A. is designed to benefit the estimated 400,000 to 700,000 unauthorized immigrants in the county without insurance.

Until now, unless those immigrants have been able to get insurance through an employer or could afford to buy it on the private market, they've had few options for care. Many have resorted to clinics or costly emergency rooms when they've needed urgent treatment. But officials at the county -- which has been reimbursing clinics  for those visits through a program called Healthy Way L.A. Unmatched -- have long recognized that such sporadic care is not conducive to staying healthy.

My Health L.A. is the successor to Healthy Way L.A. Unmatched. The new program will assign people who sign up to a "medical home" -- one of 164 community clinics countywide. The patients will go to that clinic for free primary care and health screenings, chronic disease management, prescription medications, and referrals to specialty care at county facilities.

"It’ll be a more holistic model that will allow patients to get to know their doctors, their nurses, and get care over the course of time rather than coming in when there’s more of an urgent need," said Jeff Brewer, a policy analyst with the nonprofit California Partnership, which has been working to expand access to healthcare for immigrants shut out of the federal health law.

County officials also expect the new program will cut down on the use of emergency rooms by uninsured immigrants.

Rather than reimburse clinics for individual patient visits, as it has long done, the county will instead pay them a set monthly amount for each patient they take on, regardless of how often the patient visits.

County supervisors have allocated about $61 million for My Health L.A.'s first year, which they expect to be enough to sign up about 146,000 people, Brewer said. That's about $6 million more than the county was already spending on Healthy Way L.A. Unmatched. 

Advocates hope the county will eventually increase funding so the program can cover all of the county's eligible uninsured immigrants. But Brewer said that at this point, the clinics themselves would need time to expand in order to serve so many new patients.

To qualify for My Health L.A., patients must earn less than 138 percent of the federal poverty level -- or about $16,000 for an individual -- and not be eligible for other health programs like Medi-Cal, or for subsidies under the Affordable Care Act.

There is more information on the program at L.A. County's Department of Health Services website.

Correction: An earlier version of this story incorrectly stated that Healthy Way L.A. Unmatched, the predecessor to L.A. County's new health program benefitting uninsured immigrants without legal status, had reimbursed emergency rooms for visits by these immigrants. In fact, that program only reimbursed community clinics for such visits. E.R.s were reimbursed through a different county program. We regret the error.