Covered California Releases Report On Enrollees Receiving Vital Care In Premier Hospitals Since the Health Insurance Exchange Opened In 2014

SAN FRANCISCO — Democratic Leader Nancy Pelosi visited the University of California, San Francisco (UCSF), today to highlight a new report showing that thousands of Californians who have obtained health insurance as a result of the Patient Protection and Affordable Care Act have received vital treatment — including brain surgeries, heart transplants, cancer treatment and trauma care — since January 2014, when the health exchange opened its doors.

“Today’s report is the latest evidence that the Affordable Care Act is delivering on the promise of making health care a right for all, not just a privilege for the few,” Pelosi said. “Covered California has been an enormous success. Thanks to this historic law, nearly 1.3 million Californians now have affordable coverage through the Covered California marketplace — and this data today makes clear that Californians are using this coverage to access vital, high-quality health care.”

The preliminary report from Covered California, “Delivering on the Promise of Care: Early Indicators That Covered California Enrollees Are Getting Needed Care,” includes detailed data on the unique experiences of Covered California enrollees in 111 hospitals, as well as a statewide compilation of the data for some critical services. The 111 hospitals performed nearly 40 percent of inpatient care in 2014 in California and represent a portion of all hospitals serving Covered California enrollees (not all hospitals reported data). The report also highlights other independent studies that have found that Covered California enrollees are having easy access to care and are receiving needed primary care and preventive services.

“People insured through Covered California have used their coverage to get care for broken bones, cancer treatment, elective surgeries and life-saving care at some of the best hospitals in our state,” said Covered California Executive Director Peter V. Lee. “It is this care, delivered at hospitals like UCSF Medical Center, that demonstrates how our members are getting not only emergency care, but also the critical follow-up and ongoing care they need and deserve.”

UCSF Chancellor Sam Hawgood, MBBS, said the medical center has seen firsthand how access to insurance is translating into life-saving and critical care.

“Covered California has been a model nationwide, thanks to the leadership of Democratic Leader Nancy Pelosi and others who have worked to make quality health care accessible for all,” Hawgood said. “At UCSF, we are proud to be the largest provider of cancer care for these patients among the medical centers surveyed and glad that UCSF is able to provide high-quality care to patients who otherwise might not have been diagnosed or treated.”

Highlights of the data reported to Covered California by hospitals include:

“I have had the good fortune of meeting individuals who stood before me sharing their individual health stories, and it is very powerful,” Lee said. “These data give an even fuller picture of the care being delivered across our state and bring home the fact that while health care is local, when something really bad happens, you want to be able to get to the best facility possible.”

The data included in the report represent a sample of care from 111 general acute care hospitals over an 18-month period from Jan. 1, 2014, to June 30, 2015 — the first 18 months of operation of Covered California.

The report represents a cross-section of hospitals across the state, including some of the nation’s mostly highly ranked[1] hospitals serving Covered California enrollees, such as Cedars-Sinai Medical Center, UCSF Medical Center, UCLA Medical Center, UC San Diego Medical Center, Scripps Memorial Hospital La Jolla, John Muir Medical Center facilities in Walnut Creek and Concord, and Kaiser Permanente’s medical centers in Los Angeles and San Francisco. The report also includes data from community hospitals across the state that provide essential care and services to Covered California enrollees.

The data report is available online at www.coveredca.com/pdfs/newsroom/
Delivering_on_the_Promise_of_Care_hospital_data.pdf and was released as Covered California continues in its third open-enrollment period, with 13 days remaining until the deadline for enrolling in coverage for 2016.

“Uninsured Californians need to act now so they can get the health coverage that gives them access to care in the very best hospitals in our state,” Lee said. “It’s clear from the evidence today that people who get covered are getting health care that’s changing and even saving their lives.”

Consumers who need coverage can go to CoveredCA.com to explore their options. By entering four pieces of information, they can see if they qualify for financial help to pay their health insurance premium, and they can sign up for coverage online. Consumers can also find free, confidential assistance in their communities by clicking “Find Local Help to Enroll” on the CoveredCA.com website.

Open enrollment ends Jan. 31. Consumers may be eligible to sign up at any time during the year if they have a life-changing event such as getting married, having a child or moving. Medi-Cal enrollment is year-round.

Covered California is the state’s marketplace for the federal Patient Protection and Affordable Care Act. Covered California, in partnership with the California Department of Health Care Services, was charged with creating a new health insurance marketplace in which individuals and small businesses can get access to affordable health insurance plans. Covered California helps individuals determine whether they are eligible for premium assistance that is available on a sliding-scale basis to reduce insurance costs or whether they are eligible for low-cost or no-cost Medi-Cal. Consumers can then compare health insurance plans and choose the plan that works best for their health needs and budget. Small businesses can purchase competitively priced health insurance plans and offer their employees the ability to choose from an array of plans and may qualify for federal tax credits.

Covered California is an independent part of the state government whose job is to make the new market work for California’s consumers. It is overseen by a five-member board appointed by the Governor and the Legislature. For more information about Covered California, please visit www.CoveredCA.com.