California Health Report: Clinics Wait For More Patients in Obamacare Wake

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By Genevieve Bookwalter

St. James Health Center is ready for the onslaught.

The community health clinic, one of the busiest in San Jose, sits on the corner of 2nd and Julian streets near downtown. Doctors, dentists, pharmacists and other health-care providers here treat some of the poorest patients in Santa Clara County — patients whom many expect to have newly-minted health insurance this year as the federal Affordable Care Act kicks in.

But the clinic has, unexpectedly, not seen an increase in demand for primary-care physicians, whom the newly insured were expected to tap to finally treat ongoing aches and pains.

Instead, doctors here continue to see about the same number of patients — 55,000 each year — and 35 percent of those are uninsured or underinsured. That’s because more than one-third of the patients who visit the clinic are undocumented immigrants, according to official estimates. These patients are not able to receive insurance under the Affordable Care Act.

“It’s very clear in the language that you have to be a U.S. citizen, have a green card or a working visa,” said Constance Tucker, chief medical officer for Gardner Family Health Network, which oversees a group of affordable medical clinics in Santa Clara and San Mateo counties. “You can’t get past it.”

Gardner employed outreach workers to sign up uninsured patients for Covered California, the state exchange for residents who need insurance under the Affordable Care Act, Tucker said. Only 1 to 2 percent of the few thousand screened were eligible.

“We were hoping to have more of an impact, but it hasn’t come to fruition for us,” Tucker said.

The federal Affordable Care Act was passed in 2010 and takes effect this year. Under the new rules, all U.S. citizens and those in the country legally are eligible for insurance coverage. Those who qualify and are not covered will face penalties.

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