The cinderblock waiting room at St. Margaret’s Center off Inglewood Boulevard in Lennox shouldn’t be nearly as cheerful as it is on this early afternoon in November. In the corner, a pair of tall green plants along with a single white lily are trying their flora best to spiff things up at the Catholic Charities of Los Angeles anti-poverty site. A faded painting of Our Lady of Guadalupe presides over the room.

Three women behind the counter are calling out names, answering questions mostly in Spanish and handing out application forms for programs ranging from emergency food assistance to counseling. But there’s something about their warm tone that decidedly sets it apart from that of DMV workers.

Across the room, young women sitting with children closely in tow are chatting away, also in Spanish. When the glass door opens, the booming sound of jets landing at LAX rushes in. A bent-over older man is helped to an empty seat.

Olivia Martinez has come to the Catholic Charities center with her daughter, 5, and son, 2. She’s cradling her two-month baby, wearing fuzzy pink pants, in her right arm.

The 30-year-old mother’s children have been receiving Medi-Cal — California’s version of Medicaid, the federal government’s health-care program for the poor and disabled — since she became pregnant with Maice, her 5-year-old. She knows that Obamacare (the Affordable Care Act) expanded coverage for low-income families like hers, and she’s glad about that.

But she’s also had to deal with a couple of harsh realities. Undocumented individuals like herself don’t qualify for the health-insurance program. And her husband, who is a citizen, was rejected because he makes too much money as a laborer. “I don’t understand why,” she says through an interpreter.

“We can take our children to the doctor whenever we need to, whatever the situation is,” says Martinez, more upbeat now. “We do not have to pay for the appointment or pay the hospital because they have Medi-Cal. So it saves us money, which is good.

“But my husband and I basically cover our faces so as not to show that we are sick. And we do not go to a doctor because we do not have the money to pay the fee and then for prescribed medications. Just to get there, in the first place, it costs money.

“If we were to have Medi-Cal, we would be happy,” she says. “We would have no reason not to see a doctor. We would feel better, too.”

Covered California

Online crashes, long load times and error messages plagued the initial hours and days of the first six-month enrollment period of the Affordable Care Act’s insurance exchanges last fall. Many visitors to both state-run health insurance exchanges and, the portal for residents of some 30-plus states, either couldn’t connect to these websites or were simply dropped from them in the middle of applying.

But more than 8 million people have signed up for health insurance through the act’s exchanges, which are also called marketplaces, or the federal government, according to a report from the Department of Health and Human Services. This doesn’t include the millions of Americans who bought directly from an insurer or broker of Obamacare-compliant health insurance policies. Of these customers, 85 percent received financial assistance. 

With Obamacare’s expansion of Medicaid, an additional 6.7 million individuals were found to be eligible for Medicaid or the Children’s Health Insurance Program (CHIP), not including individuals who signed up for these programs through state agencies.

“Since I signed the Affordable Care Act into law, the share of Americans with insurance is up, and the growth of health-care costs is down to its slowest rate in 50 years,” President Obama told USA Today last March, hailing the fourth anniversary of the Affordable Care Act.

Covered California, the state-run marketplace, wants to up its 1.2 million customers from last year to 1.7 million for 2015. In fact, like employees covered through work, people will be automatically renewed to their existing health insurance policy unless they change it by Dec. 15.

That’s the good news.

Some consumer advocates have warned, however, that the state’s cumbersome two-track process could be a significant monkey wrench. Another discouraging detail concerns the subsidy that nearly nine-out-of-10 California enrollees received last year to lower insurance costs. State officials have acknowledged that for 2015 these crucial subsidies may not be in the mail until the end of the year.

Moreover, while the first open enrollment period was six months, from October 2013 to April 2014, this window lasts only three — Nov. 15 to Feb. 15.

Automatic renewal may seem like a no-brainer solution. But consumer advocates are advising enrollees to shop around. Why? Because their current policy may no longer be the best deal. “We want to encourage people to shop first and not just default into a plan,” Betsy Imhoz, special projects director at Consumer Union, the publisher of Consumer Reports, told The Los Angeles Times.

‘Balancing act’

The Archdiocese of Los Angeles is also urging Angelenos already enrolled with Covered California to compare their current health insurance exchange plan with others that might now be less expensive while offering better coverage. But the crucial thing is to stay insured. And the archdiocese is imploring those individuals and families not insured to enroll for 2015.

The Catholic Church, however, continues to strongly object to portions of the Affordable Care Act mandating the coverage of contraception and sterilization services as well as abortion-inducing drugs. Even with accommodations made to the letter of the law by the Obama Administration, the Church believes dioceses, religious communities, health-care facilities and other Catholic institutions and organizations are still made to be complicit in offering these anti-life services and medications.

“For us it’s striking a fine balance between making affordable health care accessible to our people, to the most vulnerable and most needy of the poor, who may never have had it before, on the one hand,” explains Msgr. Joseph Brennan, the Los Angeles Archdiocese’s Vicar General and Moderator of the Curia. “And we balance that with our deposit of faith, with helping our folks make choices not to avail themselves of services that aren’t in line with our Catholic moral and ethical teaching and values.

“It’s incumbent upon us to always have a catechetical component, a teaching component, by informing people about these options they have in the Affordable Care Act that the Catholic Church considers immoral. Because there will be offerings that will contain provisions for reproductive and other services — as well as abortion and sterilization — that we define as morally objectionable and ought to be avoided.

“And that’s not a contradiction,” he stresses. “It’s that balancing act between compliance with the law and absolute respect of our Catholic conscience.”

‘It worries me’

A cousin of Fatima Barrera’s husband told her about St. Margaret’s Center seven years ago, when she was pregnant for the first time. A staff member informed the Salvadoran immigrant that birth costs would be covered by government health-care insurance.

“If it wasn’t for Medi-Cal, we could not pay for childbirth or any medical situations that may come up with Fatima, who is six, or my other daughter Katherine,” she says in Spanish, looking down at the three-year-old.

Both children are prone to catching colds and spiking high fevers. Fearing for their lives, she’s taken them to local ERs in a panic. “They have always received care there at no cost,” says the young mother. “So it has helped with those and other medical bills. And my Fatima had to go to a therapist because the teacher’s assistant in a Head Start program hit her. And Medi-Cal covered that, too.”

Fatima thinks a lot about getting sick herself or having an accident and needing to go to a hospital. Her husband, who’s from Mexico, gets health insurance from his work, driving a forklift in a warehouse. But she learned at St. Margaret’s Center that because she’s undocumented, she does not qualify for Medi-Cal, even after its expansion under Obamacare.

“It worries me that I do not have any medical coverage,” she says. “But I hope to get a job where I will get health insurance. Right now, I am sacrificing because I do have to take care of my children. We prefer to do that to make sure that they have access to see a doctor.”