Expansion of Health Care in CA Counties

New Health Access Report Details Dramatic Expansion in California’s County Health Care Safety-Net

SACRAMENTO, Calif., (May 20, 2016) — Today, Health Access, the statewide health care consumer advocacy coalition, is released a new report detailing the dramatic changes to California’s health care safety net programs at the county level. As the Affordable Care Act implementation has cut the number of uninsured Californians in half and the state has taken additional steps to cover all children, many California counties have extended their health care safety net programs to better serve the remaining uninsured. Counties have responded in various ways, from expanding coverage options to undocumented immigrants to providing new benefits to those already covered. A year ago, less than ten counties served undocumented Californians outside of the emergency room; on Monday, that number will expand to 47 counties.

On Monday, more Californians in 35 of the state’s most rural counties will be able to benefit from the latest expansion of the County Medical Services Program (CMSP) which includes virtually all the counties north of the Bay Area and Sacramento to the Oregon border and many in the Sierra Nevada mountains and in the Central Valley. CMSP is expanding eligibility in its main indigent care program, including raising the income level from 200% to 300% of the federal poverty level ($60,480 for a family of three). CMSP is also offering a new limited primary care benefit of three doctor visits and some pharmacy coverage to those in its program, as well as to residents (138-300% FPL) regardless of immigration status. Potentially thousands of Californians will benefit from these expansions, as well as those of other counties that have launched similar pilot programs in the last year.

Health Access’ new report, “Profiles of Progress: California Counties Taking Steps to a More Inclusive and Smarter Safety-Net,” examines the expansion in the County Medical Services Program (CMSP) along with an in-depth analyses of how six other counties adjusted their safety net programs in response to changes in need and funding. These counties include: Contra Costa, Los Angeles, Monterey, Sacramento, Santa Clara, and Fresno.

“While the Affordable Care Act has gone a long way to provide new coverage options, it’s left to California and its counties to figure out how to provide care for the remaining uninsured, including those explicitly excluded from federal help due to immigration status. Taking their responsibility seriously to provide health care to the remaining uninsured, more and more California counties are thankfully taking steps to a more inclusive and smarter safety-net,” said Anthony Wright, executive director of Health Access California, the statewide health care consumer advocacy coalition. “This month’s expansion in 35 rural counties of primary and preventive care is another step forward to a healthier California. Thousands of Californians are benefitting from these new pilot programs, but there’s more work to do in many counties and statewide to further expand and strengthen our health system on which we all rely.”

Speaking on a press conference call today were county leaders, advocates and individuals, including County Supervisors that recognized the broader benefits and policy rationale for these expansions. "Contra Costa County understands that preventative health care for undocumented families improves the public health of all our county residents.  It's a great investment to reduce healthcare costs and emergency room visits and is the right thing to do morally," said Contra Costa Supervisor, John Gioia.

The report and the press conference call also highlighted the grassroots advocacy that helped bring about this rapid change. “In a period of only about a year and a half, Sacramento community-based organizations went from basic research to advocacy, to full implementation of a county-run affordable health care program for undocumented Sacramentans that will diagnose and treat 3,000 people this year. We are actively looking for ways to implement improvements in the areas of patient navigation, capacity to serve more patients including older patients currently excluded from the program, and development of specialty care services,” commented David Ramirez from Sacramento ACT.

“As a county supervisor, I have an obligation to protect the public’s health by developing and implementing equitable and effective public policies, and appropriating commensurate resources.  Ensuring everyone has access to health care constitutes the foundation upon which we advance that mission,” said Sacramento County Supervisor, Phil Serna.

“Until we pass a comprehensive health coverage plan for all Californians regardless of immigration status, it is vital to continue supporting county safety net programs throughout the state. In Los Angeles, My Health LA has proven to be indispensable for many families that do not have the means to buy private insurance,” said Sonya Vasquez, Chief Program Officer at Community Health Councils.

"The Primary Care Access Program (PCAP) provides uninsured patients with a primary care medical home at Community Health Partnership’s association of health centers. PCAP enrollees will benefit from a coordinated system of care through our partnership with the Santa Clara Valley Health and Hospital System, including Specialty Care. Additionally, we are most proud of the fact that we are implementing a coverage program that includes a strong educational component that promotes a ‘culture of coverage’ in our families, resulting in active and engaged partners in their own health," said Dolores Alvarado, Chief Executive Officer of Community Health Partnership.

“The largest industries in Monterey County are agriculture and hospitality, two industries that rely heavily on low-wage, immigrant labor. Everyone in our region benefits from their hard work. Yet, undocumented immigrants are not allowed to participate in the Affordable Care Act.  Undocumented immigrants now represent about half of the people in California who are without health insurance and without affordable health care,” said Jack Herbig, a Communities Organized for Relational Power in Action (COPA) leader in Monterey County.

The report predicts that additional California counties will also launch similar efforts in the near future, especially under new financial structures under both state law and the new federal Medicaid waiver and its Global Payment Program, which has incentives to offer preventive care and other treatments prior to the need for emergency or episodic care. In turn, these actions at the county level also provide additional momentum at the state level for inclusive health policies.

A recording of the conference call will be available at 1:00 pm for one week; to access the recording: (800) 475-6701, access code: 394253

Report: Link 


Anthony Wright, Executive Director, Health Access California

Contra Costa Supervisor John Gioia

David Ramirez, Sacramento ACT

Lorenzo, patient with My Health LA, St. Gabriel

Carmen, patient at Gardner Family Health Network, San Jose

About Health Access California

Health Access California is the statewide health care consumer advocacy coalition, advocating for the goal of quality, affordable health care for all Californians. Health Access Foundation undertakes community organizing and education, applied research, and policy analysis, and advocates for reform to benefit health care consumers, both insured and uninsured. We represent consumers in the legislature, at administrative and regulatory agencies, in the media, and at public forums. For more information, please visit www.health-access.org.  

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