Affordable Care Act makes its mark in Yuba-Sutter

"Ampla Health is dedicated to increasing access to health care for all residents within our six-county service area," Ampla CEO Ben Flores said. "Over the next 90 days, we anticipate hundreds receiving medical insurance for the first time."

But officials for other local clinics and counties aren't so sure the 25 percent number applies here.

"One in four seems high to me, that there would be that many people who don't have medical care," said Greg Stone, executive director of Peach Tree Clinic. "Statewide, that may be. But I don't get that sense here."

Likewise, Lori Harrah, assistant director for Sutter County Human Services, said her initial reaction is the Ampla number is high in Sutter County. She noted the county's MediCal caseload has steadily increased since the implementation of the Affordable Care Act.

Sutter County's MediCal caseload was 10,181 in October 2013, just prior to implementation of the Affordable Care Act. It rose to 15,181 in October 2014 and climbed to16,944 last month.

Yuba County had 7,456 cases in November 2013 and by April 2015 had climbed to 10,023, said county spokesman Russ Brown.

Stone said MediCal patients at Peach Tree used to account for just over half of the caseload at its Yuba County clinic. Now it's at 70 percent, he said. Whether the 25 percent figure is accurate or not, there is no doubt the Affordable Care Act has made its mark in the Yuba-Sutter area — mainly through the expanded MediCal program.

Under the new regulations, those within 138 percent of their county's poverty level qualify for MediCal. In Yuba County, that's about $16,000 a year for a single person or $33,000 for a family of four.

It's difficult to get a read on the number of patients who receive care through Covered California metal plans since most are processed through the state's website. County-by-county breakdowns haven't been made public.

But those patients who qualify for expanded MediCal are referred to counties or are signed up locally.

And, while the open enrollment period that began Nov. 1 and ends Jan. 31, doesn't apply to MediCal (MediCal patients can register any time of year), there may be an extra incentive for anybody not covered to get signed up over the next month and a half.

This open enrollment comes at a time when annual penalties for not having health insurance jumps in 2016 from $325 to $695 for adults and $162 to $347.

"There are individuals that may qualify for medical insurance, but they aren't," said Ampla spokeswoman Rocio Valdez.

For that reason, Ampla is ramping up efforts on outreach programs to reach those people. It has set a goal of enrolling at least 400 to 800 uninsured people during the open enrollment period.

"There has been a lot of misconceptions among people," Valdez said. "They think it's very expensive and they won't be able to afford it. We are going after the hard-to-reach population."

One of those "hard-to-reach" groups, Valdez said, is the younger demographic who thinks they don't need ongoing coverage. Another is the middle-age uninsured people who don't qualify for MediCal.

"There are still people out there who don't have insurance for one reason or another," Brown said. "It may be a fear of being in a system or it may be a feeling they don't need it because they are healthy."

Or, he said, it may be that the penalties were still low enough to not provide an incentive to sign up.

"I think there are a number of people who choose to be uninsured," Stone said. "I think, by and large, people know about it (Affordable Care Act) and know about the tax burden (penalties)."