The number of people signing up for health insurance in Santa Barbara County has “skyrocketed” since Affordable Care Act enrollment went into effect in 2013, according to one county official who spoke Tuesday to the Board of Supervisors.
County supervisors got an update on the massive effort county departments have put in preparing for an influx of patients, and the department heads of Public Health, Social Services and Alcohol, Drug and Mental Health Departments all gave an update at Tuesday’s meeting.
The supervisors voted unanimously to receive and file the report.
The law was signed into effect in March 2010 and requires U.S. citizens and legal residents to have health insurance coverage, either through a state-run exchange, like Covered California, or a private exchange, or pay a penalty.
Since the rollout of the ACA, about 8,000 people have chosen the county as their medical home for care, according to Public Health Director Dr. Takashi Wada.
Open enrollment for 2015 is now open and lasts until February.
Because of that, the county’s caseload is still growing, and county staff are expecting an additional 17,000 enrollments by July of this year.
Daniel Nielson, director of the Santa Barbara County Department of Social Services, said 114,000 people in the county are served by Medi-Cal, which serves low-income families, seniors, people with disabilities and others. More than 34,000 of those people were enrolled since October 2013, he said.
The Department of Social Services has been the primary engine of enrollment in the county, and Nielson said the county is exceeding the state’s projections of enrollment.
Due to tech glitches from the state’s Covered California exchange, the county was facing a backlog of 10,000 applications of people trying to sign up, but those have since been worked out and the county is now down to 400 applications waiting verification, Nielson said.
Wada said the department has also seen a decrease in patients who self-pay for services, which is important to the mix of patients that the county sees. That number of patients has reduced from 28 percent to less than 13 percent, he said.
Alice Gleghorn, the newly hired director of ADMHS, was also on hand Tuesday to talk about how the enrollments have affected her department.
In 2014, 1,500 people were enrolled in mental health programs, substance abuse programs or both, she said. The department has been working to get more people enrolled, including doing outreach to the homeless, Spanish-speaking populations as well as Oaxacan families.
The Department of Social Services also had a point person working in the jail during the last enrollment period and was able to sign up those in custody before they were released.
“It was a successful effort,” Nielson said.
However, none of the medical costs for people in the jail are Medi-Cal reimbursable, and ACA doesn’t change that.
Health-care renews annually, so the county needs to make sure it keeps those patients it has enrolled coming back year after year, Gleghorn said. Making sure there are enough staff and making sure they are getting the word out into marginalized populations will also be a challenge.
The supervisors, including Supervisor Salud Carbajal, praised staff for their work on the rollout.
“I’m really happy to see we’ve been able to enroll so many residents,” he said. “To see that it’s actually working is really refreshing. I never thought we would be at this point where we are enrolling thousands of people that didn’t have insurance before.
“As somebody who had Medi-Cal when I was a kid, I just think it’s really cool.”