Continuing California’s Commitment to the Uninsured…

This weekend, the Sacramento Bee ran a story by Jim Saunders on a project we’ve been long working on: how to continue to provide care and coverage to the remaining uninsured.

While the Affordable Care Act will be historic in expanding coverage and reducing the number of uninsured by one-half to two-thirds, there are estimated to likely be 3-4 million remaining uninsured left.

This article previews a full report that Health Access will be putting out in the next week on the subject of how we ensure there is a safety-net that survives and thrives, while also being fiscally responsible, using dollars in the most efficient and effective way, using the existing infrastructure of county-based Low-Income Health Programs.

The article states this concept is getting traction from key leaders:

Senate President Pro Tem Darrell Steinberg said he strongly supports the concept of improved care for undocumented residents, which is pushed by officials of health care, labor and immigrant groups.
“I think that people who are living in this country, working hard and pursuing (citizenship) ought to be able to care for themselves and their loved ones,” he said.

Assembly Speaker John A. Pérez said he wants to ensure that counties have adequate funds to serve needy residents who lack health insurance but it’s premature to comment further until more is known about cost and number of people requiring care.

“There will always be a population that isn’t covered and there will always be an impact on counties. We need to make sure counties have the revenues and the resources to address those needs,” Pérez said.

Gov. Jerry Brown has taken no public position on expanding care to undocumented immigrants, but his budget proposal does not contemplate such a move and the federal government would not subsidize it, said Toby Douglas, director of the state Department of Health Care Services. The Brown administration is focused instead on overhauling health care in a way that’s “affordable and sustainable,” Douglas said.

“This is a pivotal moment where decisions made the next several weeks will determine wether we’re fulfilling the promise of reform for all Californians,” said Anthony Wright, director of Health Access California, a nonprofit advocacy group that supports the move….

Senate Republican leader Bob Huff, of Diamond Bar said a key consideration would be whether the program would save money by reducing the number of people who show up at emergency room with severe problems and are treated at public expense. “That’s certainly not an efficient vehicle to deliver medical care,” he said.

Oday Guerrero, 23, an undocumented immigrant participating in a two-year federal program entitling her to live and work in the United States without fear of deportation, said she has heard horror stories of undocumented immigrants struggling to get care for cancer, diabetes, heart problems or other major threats. “Everyone has the right to survive, and that’s essentially what this is about – survival,” she said.

Service Employees International Union, which represents 300,000 health care workers statewide, said in a written statement that “every California resident, regardless of documentation status or ability to pay, should have quality health coverage.”

Attempting to drum up public support for the concept, California Endowment, a private health care foundation, is bankrolling a multimillion-dollar TV ad campaign that includes undocumented immigrants questioning their access to care. “Doesn’t it make more sense to keep us all healthy, instead of treating us after we get sick?,” the TV ad says.

Daniel Zingale, a senior vice president of California Endowment, said there is growing recognition that undocumented immigrants contribute to the state’s economy, workforce and social fabric. As California’s Latino population grows, Zingale added, “there’s a recognition, I think, that it isn’t wise politics to scapegoat people on the basis of their immigration status.

In recent years, 53 of 58 counties have taken advantage of federal subsidies to create a health care network called low income health programs, or LIHPs, to serve a different, narrower population of low-income Californians – legal residents who are single and childless. Current clients of LIHPs will be eligible for Medi-Cal under the coming federal health care overhaul, meaning they no longer would use the network and their health care tab would be paid entirely by the federal government for three years. This will save counties about $1.4 billion, perhaps half of which is untouchable because of other public health mandates.

Rather than let the county-by-county networks die, advocates want to pump some of the counties’ Medi-Cal-related savings into them, perhaps $700 million, then use the LIHPs to serve about 1 million undocumented immigrants and an estimated 2 million legal residents who don’t or can’t afford to buy health insurance next year. “(They’re) pretty much going to be an empty vessel that can be utilized to serve this unique population,” said Sen. Ricardo Lara, a Bell Gardens Democrat who chairs the Latino Legislative Caucus…

The California State Association of Counties has adopted a resolution supporting a strong safety net for people who lack medical insurance in coming years, but it has taken no position on the push to expand care for undocumented immigrants. More to come..

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Health Access California promotes quality, affordable health care for all Californians.