The White House is calling that gap a "bridge period," but some county officials make it sound more like they are clinging to a life raft in stormy waters en route to Health Care Island.
Declining tax revenues mean almost every county, from Alameda to Yolo, have cut back on indigent health care services---whether it's senior home care or doctors visits for the children of undocumented workers. Take---Yolo. County assistant administrator Pat Leary---she says she's waiting for the federal aid that will come to help cover low income residents in 2014.
"Not just to hand off the baton and wash our hands of it, and say thank goodness that's no longer our problem, [but also the aid] that will help transition the county into compliance with the federal law," Leary says.
She helped the Yolo Board of Supervisors find recent cuts to its indigent health care program, YCHIP.
"It's like Sophie's Choice," Leary says.
Many California counties, like Yolo, are asking for Federal money to figure out how to transition their local health programs in advance of 2014.
There have been some immediate changes to health care law, for example, prescription drugs are cheaper for seniors, young adults can stay on their parents health plan, and the federal government is offering grants to states to investigate insurance rate increases.
Insurance Commissioner Steve Poizner is also scrutinizing health insurance rate increases with more vigor, say policy advocates like Dev Gnanadev. The former California Medical Association President, Gnanadev says more changes need to be made to the law---including more expansive prescription drug coverage.
"I don't think we should take this [as] this is the Ten Commandments, gospel from God. It is just the beginning. We got a long way to go," Gnanadev says.
There are more changes scheduled for September---including guaranteed coverage for children with pre existing conditions. Counties in California will also be able to apply for grants that will help them ready their health department for major policy changes scheduled for 2014.