Enrollment is all the buzz and kudos to the many hospitals and community partners assisting in the massive outreach efforts across Southern California.  Minimizing the number of uninsured is everyone’s goal.  However, despite massive enrollment efforts, many will remain without coverage with as many as six-out-of-10 uninsured residing in Southern California.

So, as predicted by the UC Berkeley Center for Labor Research and Education and the UCLA Center for Health Policy Research three to four million Californians will remain uninsured after full implementation of the ACA – three quarters of whom are U.S. citizens.  Taking a peek at our Southern California region, here is a glimpse of the anticipated uninsured by county in 2019:  Los Angeles: 1.2 million; Orange: 370,000; San Bernardino: 270,000; Riverside: 270,000; Ventura: 70,000; and Santa Barbara: 52,000, totaling over 2.3 million individuals – well over half of the states’ total.

There are many reasons why someone might fall through the cracks – public confusion, difficulties with actual enrollment, lack of affordability, tax penalty exemptions, immigration status, homelessness, mental illness, religion exemptions and the list goes on and on …

The numbers speak for themselves and we cannot ignore the critical need to maintain and strengthen the health care safety net. Not to mention, more than half of the remaining uninsured are predicted to have incomes of at or below 200 percent of the federal poverty level (FPL), the typical income range of safety net users. Bolstering the safety net is critical to ensuring access to care for all those named above.

The Medicaid and Medicare Disproportionate Share Hospital (DSH) programs have provided vital financial support to hospitals that serve the most vulnerable populations – Medi-Cal beneficiaries, low-income Medicare beneficiaries, the uninsured and the underinsured – since their inception.  Cuts to these DSH programs as instructed under the ACA must be delayed.  In this time of increased pressure on providers and continued uncertainty, maintaining vital DSH payments will help ensure that hospitals will be able to provide care for their patients and communities. To learn more, visit the DSH Reduction Relief Act (H.R. 1920).