SONOMA COUNTY – Sonoma County is gearing up to launch what it describes as a “bridge to health reform” that aims to provide coverage for more uninsured residents until 2014, when numerous key provisions of the health bill take effect.
The Affordable Care Act, passed in 2010, authorized states to expand coverage for childless adults of 133 percent below the federal poverty line, in anticipation of health care reform.
In order to meet that expansion, Sonoma County, along with 33 other counties, will contract with the County Medical Services Program, which is operated by the state, to implement the bridge in coverage.
In March, CMSP, on behalf of the participating counties, submitted its application to participate in the Low Income Health Program, which calls on counties to expand primary care services for the uninsured, to the state Department of Health Care Services. Locally, the Low Income Health Program will be known as Path2Health.
Path2Health, a two-year pilot project, will take effect January 2012 and last through the end of 2013.
Sonoma County has contracted with the County Medical Services Program since 1983, when the program was formed.
County health officials anticipate that Path2Health will improve coverage significantly.
“This is intended to be a bridge to health reform until 2014,” said Rod Stroud, an administrative services officer for the Department of Health Services.
Mr. Stroud said the CMSP program currently has about 8,000 enrollees, and it anticipates adding 2,000 to 2,500 enrollees in January 2012, when the Path2Health takes effect.
Sonoma County spends roughly $13.5 million every year for the County Medical Service Program, Mr. Stroud said, but receives close to $30 million in services provided. Counties that participate in CMSP also receive federal matching grants to help with the cost.
“From our perspective, they’re getting in and getting health care,” he said.
Come 2014, much of the uninsured and underinsured will be eligible for coverage under a significant statewide eligibility expansion of Medi-Cal, the state’s version of Medi-Caid.
In the meantime, Path2Health will be the main source of coverage for a much under-served segment of the population, mostly people aged 21-64 who have no form of coverage, Mr. Stroud said.
With the implementation of health care reform, all 8,000 CMSP enrollees will be eligible under the Med-Cal expansion, as well as health exchanges, where subsidies will be provided for low income individuals to purchase private health insurance.
“There will be a lot of movement between Medi-Cal and the exchanges,” Mr. Stroud said.
The Medi-Cal eligibility expansion will more than double the number of enrollees in Sonoma County when health care reform takes effect, adding 60,200 to the existing 55,000, for a total of 115,200, according to the Department of Health Services.
Some 16,000 residents are expected to gain access to private health insurance under health care reform, while the number of uninsured is expected to decrease by approximately 61,000, according to the Department of Health Services.
The estimates do not take into account population growth, the aging demographic, or the impact of the economic downturn
Copyright © 1988–2013 North Bay Business Journal
View the policy for linking to website content.