New Coalition Forms to Protect the Vital Health Care Safety Net as Lawmakers Implement Federal Health Reform

Coalition urges lawmakers to maximize federal health care reform opportunities and to protect county health care safety net funding

SACRAMENTO – A coalition of county supervisors, public hospital systems, community clinics, public health and consumer advocates, labor, and other health care providers has joined forces to promote implementation of the Affordable Care Act (ACA) in California in a way that maximizes opportunities to cover uninsured Californians while also strengthening the health care safety net – a critical resource from which the entire community benefits.

The Protect the Health Care Safety Net coalition opposes efforts by the Administration to prematurely redirect county health care funding. In a letter to legislative leaders they warn such a move would significantly erode county public health care programs and services, jeopardize the safety net and squander opportunities to invest in improved health for all Californians.

The local health care safety net provides care to millions of patients each year, serving multiple essential community roles. As major providers of care to low-income and vulnerable populations, they are leaders in extending health coverage to uninsured in Californians and offering extensive primary and preventive care services. Furthermore, a number of counties also operate public hospital systems providing burn, trauma, rehabilitation, emergency care, and physician training that benefits the entire community. Many counties also provide vital preventative health programs and services including health education, chronic disease prevention, substance abuse prevention, mental health services, vaccination programs, disease tracking, smoking cessation and more.

The coalition includes Health Access, Service Employees International Union California (SEIU), California Association of Public Hospitals, California Primary Care Association, California State Association of Counties, Los Angeles County, Western Center on Law & Poverty, County Welfare Directors Association of California, California Immigrant Policy Center, County Medical Services Program Governing Board, California Pan-Ethnic Health Network, and County Health Executives Association of California.

The letter distributed today urged lawmakers to enact policies to “extend coverage to as many uninsured Californians as possible, care for the remaining uninsured, and invest in local health care programs and services to ensure the state has a health care safety net that survives and thrives.”

The letter continues, “We want to support your leadership in the pivotal policy choices that will be made in the next few weeks. In particular . . . we want to highlight key policy positions of great importance to the 3-4 million remaining uninsured. We also want to raise concerns about the Administration’s proposal to reduce funding for local county health care programs and services – jeopardizing the safety net and squandering opportunities to invest in improved health.”

Key policy principles the group will advocate for include:

  • Expand Medi-Cal fully and urgently to maximize federal dollars into our health system
  • Continue to help the 3-4 million Californians who will remain uninsured even after federal health reform is fully implemented
  • Protect county realignment funding and support a safety net that thrives and that continues to provide critical public health services from which the entire community benefits

Protect the Health Care Safety Net believes that the Administration’s effort to redirect up to $1.5 billion in county funding is not only harmful to the health care safety net, it also is premature.

Because the federal government will reimburse 100% of the funding for state Medi-Cal expansion until 2017, there is no immediate need to redirect county funding, especially given the many unknowns associated with how many Californians will sign up for coverage. It is impossible to know today who, how many, or when people will get coverage by enrolling in Medi-Cal or Covered California. Thus, there is no way to estimate the ongoing demand for health care and associated costs to continue to provide services. Given so many unknowns and full federal funding, a more prudent approach would be to analyze implementation over the next few years to determine exactly how many uninsured moved over to Medi-Cal and Covered California and how many still will receive services from the counties.

Implementing the Affordable Care Act and a state expansion of Medi-Cal is affordable and fiscally responsible. People without coverage turn to emergency rooms for health care, often after their illnesses have become more serious and more costly to treat. We all pay the price. It is widely recognized that to improve health at a lower cost, we must focus on prevention and early treatment. Counties provide a number of important preventative services through realignment funding that benefit everyone in our communities.

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