How the Affordable Care Act Has Helped Seniors in Chinatown

Huo Qian Tan, right, sitting with a staff member in the waiting room of the medical clinic of the Chinatown Service Center. The 66 year old, who lives in Chinatown, said, “I am really happy to see a doctor without pain.” Photo: Jessica Portner

When Huo Qian Tan, a 66-year-old Chinese-American, steps into Los Angeles’ Chinatown Service Center, a weight lifts from his shoulders.

On one floor, Tan gets assistance translating important health care documents into Cantonese. On another floor, he chitchats with neighbors about social events and sees his doctor for free. For Tan, the center is among the most welcoming places in the city.

“I am really happy that I am able to see a doctor who can help me,” said Tan, sitting in the waiting room of the medical clinic one recent morning, speaking in Cantonese through a translator. Tan said he sees doctors for high blood sugar, high blood pressure, and pain and numbness in his legs.

“Without this place, my life would be very difficult,” he said.

The Chinatown Service Center is the largest community-based Chinese-American health and human service organization in Southern California, serving immigrants, refugees and others in need of assistance. In addition to medical and dental care, the center offers job training, health classes, business development and housing assistance. Staff members speak Chinese dialects, including Cantonese and Mandarin, as well as Vietnamese, Khmer (Cambodian) and Spanish.

The center, which largely serves those who have nowhere else to go, would not be a robust social or medical refuge if it were not for the Affordable Care Act.

The federal health law allowed more low-income residents to apply for and receive Medicaid, the low-income health plan funded by federal and state governments. Many people in Chinatown, after they were successfully enrolled in the program, turned to this neighborhood clinic for care. The federal Medicaid reimbursements for all these new patients largely fueled the center’s growth, doubling the budget to $8.2 million this year.

Since the Affordable Care Act took effect, the percentage of the center’s patients enrolled in either Medi-Cal or Medicare, a government health program primarily for seniors, has jumped from fewer than 50 percent to 90 percent.

Los Angeles County has 350 full-time nonprofit community clinics and health care centers, including the Chinatown center, which serve more than 1.5 million Angelenos every year. When the Affordable Care Act expanded Medicaid, known as Medi-Cal in California, L.A. clinics went from having a majority of uninsured patients to a majority of insured patients for the first time, according to Louise McCarthy, president and CEO of the Community Clinic Association of Los Angeles County.

“People want to be healthy and see a doctor, but a lot of families would not be able to be seen,” if the Affordable Care Act went away, said Romeo V. Herrera, director of the Chinatown center’s community health program. He said medications at the center have a $5 copay and doctor’s visits are $20 or less. As a result, many low-income Chinatown residents are getting long-delayed care.

“Obamacare allowed everyone to be on the same playing field,” Herrera said.

The Neighborhood Doctor

While the Chinatown center has a long history in the neighborhood—it opened in 1935 as a social service center and became a free clinic in the 1990s—it didn’t offer the same level of care before the Affordable Care Act. There was no lab for X-rays or medications and the one doctor onsite might see 35 patients a day.

Since the federal health law, the center has grown 40 percent and the clinic now has seven doctors, six dentists and six behavioral health employees. Each year, more than 13,000 people are served in the medical clinic, 6,000 in the dental clinic, and 500 people access behavioral and mental health services.

The clinic, which is a Federally Qualified Health Center, also receives grants from the federal Health Resources and Social Services Administration to subsidize visit fees, among other expenses. The Chinatown center has won large grants from banks as well, which pay for medical equipment among other expenses. As a result, patients who qualify and can prove no income do not have to pay to see the doctor.

Dennis Tse, the center’s chief medical officer said the clinic has a patient-centered, culturally sensitive mission.

“This is home away from home. You go to a new country. You get sick. What do you do?” Tse said. “We say, ‘If you need help. Come to us.’”

The seniors who come to the clinic most often suffer from four ailments—type 2 diabetes, hepatitis B, high blood pressure and high cholesterol, conditions that Asian immigrants are at high risk for, according to statistics from the Centers for Disease Control and Prevention. For example, about 20 percent of Asian and Pacific Islanders who are 20 years and older suffer from hypertension. They exceed other ethnic groups in the prevalence of certain preventable diseases, such as tuberculosis and hepatitis B, one report found.

Bay Duong, who is 65 years old, has visited the center often since she emigrated from Ho Chi Mien, Vietnam, in 2005. On a recent visit to the medical clinic, Duong carried with her a plastic bag with bottles of prescription medicine that she takes for high blood sugar, high blood pressure, high cholesterol and shortness of breath.

“No one really wants to go to the doctor,” she said, speaking through a translator. “I am really grateful to be able to come here and get treated for free because, if not, I would get really sick.”

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