The Sacramento Bee by Loretta Kalb –
October 18, 2012:
Sacramento became the latest county Wednesday to unveil a medical program to provide care for some of its poorest residents until the Affordable Care Act takes effect in 2014.
Rep. Doris Matsui, D-Sacramento, who is credited for her role in supporting the effort, told public officials and medical industry leaders at a south-area clinic that the Low Income Health Program will provide a “bridge to health care reform, ensuring Sacramento County residents have the coverage they need until full implementation” of the federal act.
Federal dollars will reimburse Sacramento County for about half of the expected $53 million cost for the 2012-13 fiscal year.
Under the program, which takes effect Nov. 1, up to 14,000 adults who do not qualify for the state’s Medi-Cal coverage may be eligible for what is essentially an expansion of Medicaid, the federal health care program.
But officials said perhaps only about 8,000 adults will be enrolled as the program ramps up over the next eight months, reducing the program’s expected initial cost.
People who live at 67 percent of the federal poverty level – or below – may be eligible for the program, provided they meet other criteria such as citizenship or federal immigration status requirements.
Sixty-seven percent of the poverty level translates to slightly less than $7,500 a year for Sacramento County residents – meaning that the coverage will be aimed at the poorest of the county’s poor.
Statewide, some 552,000 people are enrolled in LIHP so far, including residents in Placer and Yolo counties, according to the state Department of Health Care Services.
The Sacramento County program was expected to launch in August, but county officials said negotiations with hospitals required more time.
So far, Sutter Health and Dignity Health have contracted to provide care through their five hospitals in the county. Kaiser Permanente will enter contract negotiations with the county later this month.
Absent from Wednesday’s announcement were representatives from the UC Davis Health System.
“They have separate discussions going on with Sacramento County on a separate issue that they made as a condition for discussing and finalizing a LIHP contract,” said Steve Soto, regional director for Molina Healthcare, which will administer the LIHP program.
Sacramento County and the UC Davis Health System have been in conflict for years over the county’s decision to stop reimbursing for care given patients under the County Medically Indigent Services Program. A judge ruled in 2011 that Sacramento County must pay for the services.
But litigation continues, and settlement discussions have not been fruitful, Sacramento’s Chief Deputy County Executive Ann Edwards said Wednesday.
Bonnie Hyatt, spokeswoman for UC Davis Medical Center, countered that the hospital has offered to participate.
“We are still hopeful that we can work out the terms of that participation,” Hyatt said, “and our absence from today’s event … has nothing to do with the lawsuit.”
Those enrolled in the new program will be eligible to receive care on a par with services provided to individuals on Medi-Cal.
Those include physician services, specialty care, emergency care, inpatient hospital services, prescription medicines and more.
Eight primary care providers will participate in the program to start, including the county Primary Care Clinic. Fifty or more pharmacies will be in the network along with about 50 specialty providers, such as eye care and therapy centers or individual doctors.
Sacramento County will decide eligibility. Individuals can request a LIHP application from the county Primary Care Clinic at 4600 Broadway.