Some are calling it the biggest change for U.S. health care since the start of Medicare nearly 50 years ago. Whether you love it or hate it, embrace it or fear it, the Affordable Care Act is moving ahead. Starting October 1, people who are now uninsured and can't afford to be can start buying coverage at the online health insurance marketplace, known here as Covered California.
At a bustling health clinic in San Francisco's Chinatown-North Beach neighborhood this week, patients were getting prescriptions filled and waiting for medical appointments.
Health care worker Min Zhang is sitting at a table near the front door, handing out health care information. Zhang says a lot of people are asking her about Obamacare.
"A lot of times the questions will be, ‘If I currently have medical [insurance] and Medicare, will I be affected?’” Zhang said. “Or a lot of people will ask, ‘Can I register right now and reserve my place on October 1 so when I come back you'll be able to help me out?’”
Standing down the hall is Adrian Nuñez. He oversees outreach and enrollment in public health programs in San Francisco. Nuñez compares implementing this extremely complex health care law to flying an airplane – as it's being built.
“We're about a week and a half away from October 1, yet we don't have dates for training for some community-based organizations,” Nuñez said. “I think we're okay with this because there are alternative options, but it’s just an example of how we're ready to go but we may not have all the pieces there to get started 100 percent on October 1.”
The vast majority of Californians won't be affected by Obamacare – they get insurance through work or are seniors on Medicare. Still, Nuñez says he hears questions like, "What will it mean for me?"
Nuñez also said that, “for some who already have health coverage it may not be a big change that they'll see upfront. But for those people who are uninsured it's going to be a big, big change – not only because they'll have new options, there's going to be some very affordable options and for some individuals it'll be free.”
Of the more than five million Californians eligible to purchase coverage online starting next month, probably half are Latinos.
Ads paid for by Covered California will be airing on Spanish-language television and radio throughout the state.
The state is also hiring and training thousands of people who will be knocking on doors, organizing house parties and setting up tables at festivals. These grassroots educators, or promotores, will also be talking to Latinos where they shop.
“My name is Tamara Centeno. I'm a leader promotora for Vision y Compromiso, and what we do is do outreach and education for the Latino community.”
Tamara Centeno describes details of the new health insurance exchange to Sergio Gonzales, manager of Milagros de Mexico pharmacy in Oakland.
Centeno works for one of many advocacy groups that have received funding to educate hard-to-reach Californians. We're standing inside Milagros de Mexico, a drugstore serving Oakland's Latino community. This is one of the places Centeno will disseminate information about the online health care exchange. Centeno tells me many people she's talking to haven't even heard of Covered California.
We asked Centeno, “What are some of the barriers you have to overcome, what are some of the issues that people like you, promotores out in the community, are going to have to overcome in order to get people to at least get the information and perhaps sign up and get insurance?”
“One of the barriers,” Centeno said, “is that they could get a lot of information by Internet. But in our Hispanic community they don’t feel comfortable with the Internet, so they prefer face to face.”
And, Centeno says, many Latinos get confused and frustrated by complicated health insurance applications, something she hopes Covered California will change.
She says it can help them “really compare apples to apples – what it is with the different plans so it will be easier for the community to access health plans and to make better decisions.”
Throughout the nation, Obamacare faces stiff resistance. Republicans in Congress are even trying to shut down the federal government to prevent the new law from being funded. But here in California, it's full speed ahead, ready or not.