AS THE NATIONAL debate over health care reform rages on, North Olympic Peninsula providers are bracing for a new wave of patients who soon will be eligible for Medicaid or subsidized private insurance under the Affordable Care Act, better known as “Obamacare.”
Health care officials say Clallam County lacks enough providers to handle an estimated 6,000 to 8,000 residents who will become insured when new individual health plans take effect Jan. 1.
“We are anticipating shortages of primary care, and it’s possible that people will not immediately be able to find a medical home,” said Dr. Tom Locke, public health officer for Clallam and Jefferson counties.
“Even if they can’t find a provider right away, there are still going to be enormous benefits to them.”
(SEE RELATED STORY TODAY: “Q&A: Answers to your most pressing questions about you and the Affordable Care Act,” https://www.peninsuladailynews.com/article/20130929/NEWS/309299989 .)
Jefferson County has a network of primary care providers in place to treat the estimated 3,200 uninsured residents who will qualify for Medicaid expansion or income-based subsidies, Jefferson Healthcare officials said.
According to current estimates, there are 11,000 uninsured in Clallam County and 4,600 people without insurance in Jefferson County.
Illegal immigrants are excluded from the ACA. Others are projected to remain uninsured for various reasons — this group includes young and single people who don’t believe they require health insurance.
Under the law, failure for an individual to purchase health insurance will result in a penalty in 2014 of $95 per adult, $47.50 per child or up to $285 per family, or 1 percent of family income, whichever is greater — a sum far less than the annual cost of coverage.
Open enrollment for the Washington Healthplanfinder insurance exchange — an online marketplace for individuals, families and small businesses to compare plans and pick one that works for them — begins Tuesday.
For details, visit: www.wahealthplanfinder.org.
Those who already have insurance, including Medicare, don’t need to worry about the exchange.
While primary care access remains a challenge for Clallam County and other rural areas, Locke and others said the Affordable Care Act will keep people from going bankrupt if they have a catastrophic illness.
It also will reduce uncompensated care for hospitals, which amounts to about $10 million annually for both Olympic Medical Center and Jefferson Healthcare.
OMC, Jefferson Healthcare and Forks Community Hospital treat every patient that comes to their emergency rooms, regardless of whether they can pay.
Dr. Rebecca Corley, chief physician officer at Olympic Medical Physicians, said OMC, Family Medicine of Port Angeles and the Jamestown Family Health Clinic are actively recruiting primary care providers.
“It’s a challenge to be competitive salary-wise with cities and other states that have a much higher reimbursement,” Corley said.
About 20 percent of the population lives in a rural area, Locke said, but only 9 percent to 10 percent of physicians work in a rural area.
Rural areas also tend to have an older, lower-income and sicker population than cities, he added.
“That’s the context for this,” Locke said.
“We have extreme challenges in rural areas, but the Affordable Care Act is part of the solution.”
OMC Chief Executive Officer Eric Lewis, who has tracked the intricacies of health care reform for years, raised the issue of physician shortages at the Sequim-Dungeness Chamber of Commerce meeting last week.
“Right now, the primary care system is near capacity in terms of who they can see,” Locke said, “but there are serious efforts underway to increase that capacity.”
In addition to recruiting physicians, advanced practice clinicians and advanced practice registered nurses, OMC is working on a comprehensive workforce analysis and taking part in a community health-needs assessment. A community health summit is planned for Oct. 30.
At least initially, Volunteers in Medicine of the Olympics, or VIMO, will not be affected by the Affordable Care Act, Executive Director Larry Little said.
The free clinic in Port Angeles provides primary care, dental care and other services to about 1,400 patients who don’t have health insurance.
“We will still continue to see the same patient population because of provider shortages here,” Little said.
“With the expansion in Medicaid, at least the local hospital will be paid by many more individuals now.”
VIMO is exploring the possibility of accepting Medicaid patients, but that decision has not been made.
Little said the decision to accept Medicaid payments would require “lots of consideration.”
He added: “There is going to be a change, and it’s going to take place on Jan. 1.”
“All of a sudden, there’s a bigger pool of money to provide primary care,” Little said. “We just don’t have the providers in the pipeline to immediately fill that void.”
Dr. Joe Mattern, Jefferson Healthcare chief medical officer, said his hospital made a “real investment” in the last decade building up the primary care workforce in Jefferson County.
Mattern noted that Jefferson Healthcare is “already serving a good portion” of the uninsured population.
“I think we also have existing capacity to take on new patients,” he added.
Jefferson Healthcare CEO Mike Glenn predicted that the Affordable Care Act will affect Jefferson County “in a very positive way.”
“Both Olympic Medical Center and Jefferson Healthcare, I think, are well-positioned to step into this phase of the Affordable Care Act to the benefit of both of our communities,” Glenn said.
Dr. Scott Kennedy, OMC chief medical officer, told commissioners at their Sept. 18 board meeting that OMC is “ready to move into action” on the Affordable Care Act.
Locke described the current health care system as a “national scandal” because of the high costs and inability of people with pre-existing conditions to get insurance.
“I think the real goal should be universal health care access,” Locke said.
VIMO’s Little said the long-term vision of the Affordable Care Act “makes sense” because of its emphasis on primary care.
“If people are healthy, it’s going to cost less in the long run,” he said.
Little cautioned that the long-term success of the law “remains to be seen.”
When asked to predict how the Affordable Care Act will play out, Corley said: “My crystal ball has a big crack in it.”
“Regardless of what our political leanings are, hopefully, at the end of the day, we as a nation will be better because of it,” Little said.
“I really hope it works. I just want the best for us.”
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Reporter Rob Ollikainen can be reached at 360-452-2345, ext. 5072, or at rollikainen@peninsuladailynews.com.
