
Kellie Schmitt
Affordable Care Act Blogger, Freelance Health Reporter
Affordable Care Act Blogger, Freelance Health Reporter
I write for the Center for Health Journalism's Remaking Health Care blog. Previously, I was a health reporter for the Bakersfield Californian, a staff writer for the San Jose Mercury News, and a business reporter for the San Francisco Recorder. I spent two years reporting from China for publications including The Economist's Business China, China Economic Review, and CNN Travel.
In 2012, I was a Health Journalism Fellow. My project examined the high number of foreign-trained doctors in California's Central Valley, a series which won awards from the Association of Healthcare Journalists and the California Newspaper Publishers Association.
I also worked with the Center for Health Journalism's multi-part, collaborative series on the devastating toll Valley Fever has had on California's Central Valley.
In Washington state, a lack of psychiatric beds has led to a court ruling that says patients can't be held against their will in ERs while awaiting long-term care. While the ACA has expanded benefits, it has also revealed just how scarce resources often are.
The ACA is projected to save hospitals billions in uncompensated care, with the biggest savings in states that expanded Medicaid. But the good news for some hospitals is tempered by ongoing cuts in federal funding that could threaten the sustainability of safety-net systems.
With the upcoming enrollment for California's health exchange expected to be half as long and twice as hard, officials are looking to improve on call wait times, outreach to diverse communities, and persuading the remaining uninsured to sign up.
The Affordable Care Act has spurred new conversations about how to best deliver mental health benefits. Ideas range from incorporating more mental health services into primary care visits to the use of avatar systems to help schizophrenics control hallucinations.
One way the Affordable Care Act aims to spur innovations in health care delivery is through the CMS Innovation Center. Four California-based projects give a sense of the kinds of programs and ideas the office is currently funding and tracking.
For one mental health counselor in Washington state, Obamacare has improved mental health care for many of her clients. With some providers seeing an uptick in newly insured clients, more adults and children are getting long-needed care.
New data show that tax credits have dramatically lowered premiums for those on Obamacare plans. But for employees stuck with high-deductible plans, big out-of-pocket costs can drain bank accounts and incentivize going without care.
A recent report finds California's safety-net hospitals could face huge funding shortfalls by decade's end, as federal payments for uncompensated care are cut. Meanwhile, rising medical costs and the remaining uninsured will put added pressures on the system's solvency.
A May report found a modest increase in Medi-Cal spending could give about 700,000 undocumented Californians access to care. Meanwhile, in the Salinas Valley, some say an employer-sponsored trust could provide essential care to farmworkers.
In response to the growing shortage of primary care doctors, some advocate for expanding the roles of nurse practitioners to expand access and lower costs. But the suggestion has met with pushback from some physician groups.