With Obamacare on the rocks, LA ‘mega-clinics’ could be in higher demand

Daily News (Los Angeles, CA)

Jan. 20--Noah Lopez's gums are swollen. His jaw aches. It's hard for him to chew.

But come early Friday morning, he'll find some relief when he walks inside a downtown Los Angeles building after spending the night at a nearby park. He will be among the first of nearly 1,000 people who will receive free dental care and other medical treatment.

"It's terrible to live with this pain," the 42-year-old Long Beach man said Thursday. "I've taken it for two years. I called everywhere to help me. I'm glad I'm going to get it here."

Lopez will be among many of the uninsured and underinsured from Southern California who will line up at The Reef on Broadway Street for dentures or an aching tooth or two to be filled or pulled, a new pair of bifocals or speciality care they otherwise can't get, all at no cost.

The services are coordinated by Care Harbor, which brings together resources and volunteers to provide the free medical, dental, vision and preventative care. More than 600 physicians, nurses and other staff from UCLA and the Buddhist Tzu Chi Medical Foundation, among others, have volunteered their time to provide those services that begin Friday and end on Sunday. All those who receive the services lined up last weekend for the wristbands needed to enter the event.

The three-day mega health clinic will be held inside The Reef, an 850,000-square-foot building where designers and other creative types display their work. On Thursday, volunteers worked to prepare the second floor of the building with signs, 45 examination rooms and dozens of long display tables.

"I like to say it's what's right and what's wrong with health care all at the same time," said Don Manelli, president and founder of Care Harbor, as he surveyed all the preparations taking place around him on Thursday.

Manelli has long been part of organizing such events. In 2009, one of the largest such clinics in the nation was held at the Inglewood Forum. About 6,000 people attended then but many had to be turned away. Images of those mega-clinics, held nationwide and primarily in rural settings, became symbolic of the fractured health care system before the Affordable Care Act. Many Americans from rural areas drove hundreds of miles to get an abscessed tooth pulled or an expensive prescription filled.

Now, when a promise was made to repeal and replace the Affordable Care Act by President-elect Donald Trump, who will be sworn in and take office Friday, many worry about the unknowns and future of health care. Some said such mega-clinics likely will not only continue to be held, but may be more in demand.

"Our needs tomorrow will be different than our needs yesterday," Los Angeles County Supervisor Mark Ridley-Thomas said Thursday while visiting preparations made at The Reef. Before Obama signed the Affordable Care Act -- known as Obamacare -- in 2010, there were 2.2 million uninsured people in Los Angeles County. That number is now at 750,000.

"It means we didn't have the chance to get to all of them," Ridley-Thomas said of those who remain uninsured. He said such mega-clinics provide a safety net to those in need and such services should be protected.

Among those who are uninsured are the undocumented immigrants such as Lopez, who are not qualified for federal subsidies to help pay for a health plan under the Affordable Care Act. In June, Gov. Jerry Brown signed a bill that asked the federal government to waive a major provision under the Affordable Care Act to allow California's undocumented immigrants to buy unsubsidized health plans on the state's health plan exchange.

On Wednesday, that request was withdrawn by California lawmakers, who called the decision "the first California casualty of the Trump presidency," said state Sen. Ricardo Lara in a statement to reporters.

Still, even with insurance, there remain holes in the health coverage offered under Obamacare, some at Care Harbor acknowledged. For example, affordable dental care remains out of reach for many. The state's program, known as Denti-Cal, pays among the nation's lowest reimbursements rates for dentists, which is why many don't participate.

Also, Medi-Cal covers vision exams but not new glasses. And speciality care among those patients who use community health centers can take months, even a year, to access, said Dr. Natalie Nevins, who oversees the medical services for Care Harbor.

"Access to speciality care is very difficult," Nevins added.

Manelli said he doesn't see mega-clinics such as those organized by Care Harbor disappearing any time soon. In fact, Care Harbor is planning to organize a clinic in Detroit.

Organizing such clinics cost about $300,000 in donations, Manelli said, with much of the funding going toward security and renting out space. But he said the effort is important because so many people remain in need.

"It's starts with a belief that people deserve what we're giving them," Manelli said. "There are people who will say, 'they don't deserve it. They didn't pay for it.' But health care is a right."

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