Healthy Way LA (HWLA) was a free public health care program available to underinsured or uninsured, low-income residents of Los Angeles County. The program, administered by the Los Angeles County Department of Health Services, was a Low Income Health Program (LIHP) approved under the 1115 Waiver. HWLA helped to narrow the large gap in access to health care among low-income populations by extending health care insurance to uninsured LA County residents living at 0 percent to 133 percent of the Federal Poverty Level (FPL). Individuals eligible for HWLA were assigned to a medical home within the LA County Department of Health Services (LADHS) or its partners, thus gaining access to continuous primary care, preventive and specialty services, mental health services, and other support systems. HWLA was one of the few sources of coordinated health care for disadvantaged adults without dependents in LA County. HWLA was succeeded by My Health LA, a no-cost health care program for low-income Los Angeles County residents launched on October 1, 2014.
History
California's LIHP was a health care coverage program for low-income, uninsured adults. The program began in 2010 and was an extension of the original 2007 Coverage Initiative from the previous Section 1115 Medicaid Waiver. LIHPs operate at the local level and are administered by the LADHS.6 As the country awaits the full implementation of the Patient Protection and Affordable Care Act (PPACA) in 2014, LIHPs in California assist counties in providing insurance for their uninsured population. HWLA was the local LIHP for those eligible in LA County. It began enrollment in 2007 in accordance with the terms of the previous Section 1115 Medicaid Waiver, as part of the “Coverage Initiative” for low-income uninsured adults. HWLA provides health care coverage expansion to uninsured individuals and attempts to stabilize safety net provider systems. With the insurance mandate included in the PPACA, HWLA was scheduled to end upon the implementation of the PPACA in 2014. HWLA and other LIHPs receive funding from California's “Bridge to Reform” Section 1115 Medicaid Demonstration Waiver. The waiver produces up to $7.7 billion in federal matching funds for Medicaid available over 5 years. LIHPs have two program components: the Medicaid Coverage Expansion (MCE) and the Health Care Coverage Initiative (HCCI). Each county has the option of either choosing to cover only MCE individuals who are below 133 percent of FPL or both MCE and HCCI adults who have family incomes between 133 percent and 200 percent of FPL (or a lower limit determined by the county).8 When the PPACA's health care coverage expansions come into effect, MCE adults will transition to Medicaid with 100 percent of federal matching. Most HCCI adults will be covered under Covered California, the State's Health Benefit Exchange.
Program features
HWLA enables enrollees to choose a medical home from a list of clinics and health centers operated by the LADHS or its community partners. Patients receive continuous and coordinated care by a team of providers within their medical home and have access to both primary and specialty care services. As HWLA members, enrollees may also receive health care services at other Los Angeles health centers, hospitals, ambulatory care centers, and clinics within the HWLA network. Nonemergency care received outside of the HWLA network or outside Los Angeles County was not covered by HWLA.
Patients meeting the following requirements are eligible for HWLA: Uninsured health status US citizenship or legal permanent residence for at least 5 years Los Angeles County residency Age of 19 to 64 Monthly family income at or below 133 percent FPL Not currently pregnant Not eligible for Medi-Cal or Healthy Families
Individuals receiving health care services and HIV care by Ryan White (RW) or the AIDS Drug Assistance Program (ADAP) may also be eligible to enroll in HWLA.
Healthcare benefits
HWLA enrollees have access to both outpatient and inpatient services at no cost. Primary care and preventive services are provided, as well as access for referrals to a range of specialty services, a nurse support telephone line, interpreter services and acute care services. A large emphasis has been placed on providing access to mental health services, which are also available to enrollees.