My Health LA: A model for affordable healthcare

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Last year, Los Angeles County rolled out a new $61 million health care program for undocumented immigrants. It’s called My Health LA, and it’s designed to provide free, ongoing primary care, prescription medicines, labs, and tests.

In a departure from previous county programs, patients now choose only one clinic from about 200 community clinics and stick with it. The clinic is called a medical home, and for some patients, like 51-year-old Martin Machain, it’s like a home away from home.

“I don’t have a family here, so I feel that the clinic’s got my back,” Machain says. “They treat me right.”

A year in, patients say it’s keeping them healthy. Enrollment has climbed to 131,000 people, but that’s still less than half of LA’s undocumented, uninsured population. The funding falls far short of including everyone who is eligible in LA, and clinics only cover basic services in-house. The County’s Board of Supervisors has only budgeted enough to cover 146,000 people.

But regular checkups and prescriptions are enough to keep Machain coming back. He’s a diabetic with asthma and has kidney problems. He recalls the days when he had no other choice but the county hospital emergency room for no-cost treatment. Since My Health LA focuses on preventing and stabilizing problems before they get worse, patients can see a doctor every few months, not just when they have major health complications.

A recent USC/LA Times poll found that nearly half of California voters are against subsidizing health care for undocumented immigrants. But health experts say programs that fund preventative health care are more cost-effective for taxpayers than treating people in the ER.

“We could save more by giving people services up front, rather than waiting for conditions to appear and then dealing with it after the fact,” says Dr. Michael Rodriguez, a UCLA Medical School professor and public health expert.

My Health LA has become a model for other cities and counties. However, challenges remain in reaching the entire eligible population and offering easy access to services beyond basic care, including specialty and mental health care.

Martin Machain makes lunch in his kitchen. He works nights as a janitor, cleaning industrial kitchens for seven hours straight. He enrolled in My Health LA a year ago, and visits his clinic for both health and dental check-ups.
Martin Machain walks down the street to the clinic, only a five-minute walk from his home. “I feel like I’m amongst family when I go to the clinic,” he says. “Maybe it’s because I’m alone here, because I have no family here. But when I get there, I feel at home.”
Martin Machain gets his right eye checked. A childhood accident left him blind in his left eye. He’s diabetic, and goes in for routine doctor’s appointments once every few months.
Juana Granados waits outside the St. John’s community clinic in South LA. She says the biggest benefit of My Health LA is the free medicine she gets for her diabetes and high blood pressure.
About 200 community clinics across LA County participate in My Health LA. For the most part, new patients can only sign up for the program inside a clinic. This particular St. John’s clinic has enrolled more than 6,000 patients.
Juana Granados (right) gets her blood pressure checked at the clinic before her doctor’s appointment. She’s come in today for treatment of her chronic knee pain.
Almost 92 percent of My Health LA patients speak Spanish. Most of the St. John’s staff is bilingual and can easily communicate with the clinic’s population.
Diabetic patients dance to catchy Zumba beats at a group exercise session. Diabetes hits immigrant communities especially hard, so this class at St. John’s clinic teaches patients the essentials of good nutrition and fitness.
Gloria Velasquez (center) is a housekeeper who says she could never afford out-of-pocket medical fees. She’s been participating in the clinic’s exercise class for a long time, even before she enrolled in My Health LA.