WatchSonoma Watch

Sonoma County gets early start to federal health law

More than 6,000 residents added to rolls of federally insured


More than 6,000 residents in Sonoma County and 400,000 in the state are getting an early taste of Obamacare, receiving a version of health care coverage promised to 30 million Americans nationwide.

The coverage is part of California’s early expansion of the federal Medicaid program, a key component of the health care law promoted by President Barack Obama. Only six other states in the country and Washington, D.C., have such programs.

Meanwhile, Texas, Florida, Wisconsin and Mississippi are among the states vowing not to participate in the 2014 expansion of Medicaid and the creation of state health benefit exchanges. Their refusal could leave millions without health care coverage.

“California took the lead on implementing the spirit of the Patient Rights and Affordable Care Act,” said Marion Deeds, interim assistant director of the Sonoma County Human Services Department. “It’s really the first generation of expanded Medicaid.”

For decades, Medicaid has paid hospital and health care bills for the nation’s poorest residents. But many working people without company-paid health insurance often didn’t make enough money to pay for private insurance, leaving them uninsured during medical emergencies or when their health failed.

The intent of the health care bill is to bring that huge segment of the population into government-funded health care coverage by 2014, largely through local clinics such as the Santa Rosa Community Health Centers or the Petaluma Health Center.

What that will look like nationally already is happening in Sonoma County under a program called Path2Health, a precursor to Obama’s health care expansion.

After years of living with no health insurance, Billie Jo Bianchi, 63, of Petaluma now finds herself with a Path2Health insurance card.

While she appreciates the coverage, she said that filling out all the paperwork to get it has been a byzantine process.

Bianchi, who has fourth-stage liver disease and other health issues, said the last time she had health insurance was when she worked for Viacom two decades ago. If she had continued her health insurance, she might have been able to treat her illnesses earlier.

“It’s been one thing after another,” Bianchi said. “The only thing I don’t have yet is diabetes.”

Path2Health is open to adults between the ages of 19 and 64 and it has no property or asset restrictions for qualifying.

It is part of California’s low-income health program aimed at helping local governments transition to federal health care changes. The cost of funding the programs is split 50/50 between counties and the federal government.

But in 2014, and for two years after that, the federal government will assume 100 percent of the cost of expanded Medicaid coverage. After 2016, the federal share will drop to 90 percent.

The federal government allowed counties to set income limits, and in Sonoma County, the income eligibility for Path2Health coverage was set at 100 percent of the poverty level. By comparison, the income ceiling for Medi-Cal, the state’s health care program for the poor, and the county’s own health coverage for the indigent is 66 percent.

There is also no share of cost as there is with Medi-Cal, where 19 percent of enrollees split the cost with the program. Among this group, the average share of cost is $445 a month.

Deeds said that in the 1980s, Medicaid covered a larger segment of the population, but the program was scaled back because of the severe recession during that decade.

California requires counties to provide medical care for indigent residents, so a consortium called the County Medical Services Program was established to provide coverage for those who were falling through the cracks. There are currently 35 mostly rural California counties that are part of the consortium.

In 2014, those enrolled in Path2Health will be rolled into the health care law’s expanded Medicaid program.

Ann O’Leary, director of the children and families program at the Center for the Next Generation, a nonpartisan San Francisco-based think tank, said programs like Path2Health give California a leg up on implementing Obamacare in a timely manner.

The state was the first in the nation to pass legislation enacting Health Benefit Exchanges, the commercial mechanism established by the health care law that will offer competitive insurance with premiums that are subsidized by tax credits.

Local health care experts estimate that 30,000 Sonoma County residents will become newly insured through exchanges while another 20,000 residents will ultimately become insured through Medicaid expansion after 2014.

Deeds said Path2Health was expected to cover 10,000 county residents who would not have otherwise been eligible for Medi-Cal.

“The counties are not on the hook for this expansion immediately,” Rumble said. “There may be an expanded cost next year in the level of contribution we make.”

(You can reach Staff Writer Martin Espinoza at 521-5213 or martin.espinoza@pressdemocrat.com.)

22 Responses to “Sonoma County gets early start to federal health law”

  1. Fiscal Conservative says:

    They finally said something I agree with!

    Mockingbird writes:
    “Bear- We’re both spitting in the wind on this site.” Well said!

  2. bear says:

    @ mockingbird

    BIG foolish grin.

    Yes, spitting into the wind. A lifetime habit of mine. Best accomplished if you duck fast. I suspect you understand.

    And no, I’m not “dripping with hate.”

    I just favor personal responsibility for hideously bad policy.

  3. MOCKINGBIRD says:

    Bear-we’re both spitting in the wind on this site. People posting don’t bother to do their homework on how things work with the healthcare in other countries-they just THINK they know, or heard something somewhere. Michael Moore just sent me a letter with a link to a diehard conservative Republican woman’s post who moved to Canada. She thought she’d HATE the health care there. She finally had to admit that she got better care there, more comprehensive care, without the wait than she would here where she had to pay for everything so only went when she had to. Complete access to wellcare and sick care services throughout her pregnancy and beyond. Canada wants healthy babies born so they take care of the mothers. They want those babies to stay healty. What a crazy policy, right?

    The Canadians are smarter than we are.

  4. Taxpayer says:

    BEAR seems to be dripping with hate.Sad.

  5. bear says:


    Oh, don’t crap all over me. The country is in an economic and foreign policy crisis that conservatives (republicans?) can’t evade.

    Why don’t you all “man up” (possible?) and accept responsibility for your mistakes?

    Hey, Bill Clinton was being impeached on the basis of illegal wiretaps.

    How effective was that? It gave us GW Bush. Still waiting for a defense of that idiot.

  6. Follower says:

    It wasn’t that long ago when your Family Doctor would come to your home. When he would bill you and you would pay off the bill over time.
    But it was long ago enough for people to forget what the term “Family Doctor” used too mean.
    That was before your Doctor needed to carry obscenely expensive Malpractice insurance to defend against the flood of frivolous law suits.
    When your Doctor saw you as a patient, not a potential liability.

    Here comes Obamacare to the rescue!

    Now your Doctor can treat you with full knowledge that the Government will pay, pay, pay!

    And if you don’t “play ball” your Doctor can rest assured that the IRS will be knocking at your door.
    And none of you libs seems to have a problem with that!?? Amazing!

    So we all go like good little sheep into the bottomless abyss of yet another Government Bureaucracy that will quickly grow into a cathartic, endless maze of paperwork and waste run by people who had long ago given up on “caring” about the person behind the reams of forms. (That would be YOU by the way!)

    And while we build new Hospital after new Hospital preparing for the inevitable aging of the Baby Boomers, we will build a monstrosity that will like all other Government Socialist programs eventually collapse under it’s own weight.

    But don’t worry… you’ll all be dead and gone by then and your Grandchildren will be stuck with the bill you couldn’t pay and a Health Care system run by the IRS.

  7. bear says:

    Do not tell me that republicans are not in favor of financial degregulation.

    Do not tell me that the republicans have not strong-armed democrats into unwise legislation. It’s called bullying, or a forced trade-off. Real compromise involves both sides giving up a little – something that republicans seem to have forgotten.

    I’ll never forgive Bill Clinton for giving us GW Bush. An endless disaster.

    I’ll never forgive democrats for caving on war powers issues.

    Romney seems to have a genetic understanding of bullying. Why couldn’t the republicans come up with a better candidate? I’d like Ron Paul, if he didn’t have a son who is a whack job.

    Follow the money.

    I don’t see how Romney can be considered smarter or more experienced than Obama. Obama has been a conservative president, who didn’t skate through Harvard. Romney is a legacy – the most evil term I could use. That means someone whose daddy got him into college.

    Romney is a prep school jerk.

    I stand by everything else I said, which you ought to read again.

    We’re all not that far apart. Can’t we try to agree on something?

  8. Jean Anderson says:


    Get a clue.

    Your absurd posts are getting old and very tired.

  9. GAJ says:

    Evil Republicans may have had a hand in deregulation, but I was Clinton that kneecapped Glass-Steagall:

    “The Gramm–Leach–Bliley Act (GLB), also known as the Financial Services Modernization Act of 1999, (Pub.L. 106-102, 113 Stat. 1338, enacted November 12, 1999) is an act of the 106th United States Congress (1999–2001). It repealed part of the Glass–Steagall Act of 1933, removing barriers in the market among banking companies, securities companies and insurance companies that prohibited any one institution from acting as any combination of an investment bank, a commercial bank, and an insurance company. With the passage of the Gramm–Leach–Bliley Act, commercial banks, investment banks, securities firms, and insurance companies were allowed to consolidate. The legislation was signed into law by President Bill Clinton.”


  10. Jim Bennett says:

    It’s a miracle.
    I look at my favorite alternative news site and look:

  11. bear says:

    Local government has “chronic budget problems” because of republican policies that deregulated the financial and mortgage industries, and (even worse) defunded enforcement efforts.

    Oh, and then there’s the two unfunded wars that accomplished nothing.

    Maybe you would like to chat with the families of soldiers who died, or were maimed for life, for nothing?

    So republicans take the bad economy and use it as a weapon? Cheap and heartless move.

    As I see it, no republican is eligible to run for office because they can’t remember what happened before 3.5 years ago.

    Maybe psychological treatment is needed.

    GW Bush will NOT be attending the republican national convention. Could this be an accident, or an admission of rancid incompetence?

  12. Reality Check says:


    Yes, SF is prosperous despite higher costs of doing business. But then, location, tourism, and other factors make comparing it to Sonoma County a stretch.

    One downside to SF’s policies. It’s becoming a city by and for the rich, where African Americans and other non-Asian minorities can no longer afford to live. That limousine liberals in SF fund a health care problem for the servant class is touching.

  13. Jim Bennett says:

    No surprize that the leading community setting an example for a UN Agenda 21 template: Sonoma County will help lead the way in A21 Health Care.

    What’s also scary and noteworthy is that the story shows a vacination picture.

    Wow, they don’t waste any time.

    Psychic prediction:
    Very soon our highjacked evil nanny state will release their latest contrived pandemic. Which will be an instrument for everything they long for, and one of the main reasons Obamacare was rammed down our throats. Mandatory vaccinations being synonomous with our mandatory ‘healthcare’.

    Polarization, as the populace is quickly devided between the haves and have nots. This being those that have received ‘The Shot’ and those that have not.
    Escalating fear justifying a mandatory policy for all citizens to be given this toxic vaccine.
    Population reduction.
    A false flag excuse to formally roll out an imposed marshall law which would provide more of the music they want us to dance to.
    Unfortuneatly our local government’s radios are tuned into the UN’s station.

    We are really in a kind of clandestine World War III and most citizens don’t even know it…yet.

  14. Commonsense says:

    What I find most interesting is how little both those in government and us on the outside really know about this new law. Apparently reading and understanding it prior to voting on it wasn’t a requirement. Whenever I asked questions of our local rep(s), like Woolsey and Feinstein, the responses are provided in the form of a form letter that simply re-states the general feel good line of getting millions healthcare who didn’t have access before. Access has never been a problem, just visit one of your local ER’s, the problem has been affordable health care insurance through private carriers, other then the already existing public coverage available through Medi-care and Medi-caid. I’ve asked exactly where we get the number of between 7 and 13 million “uncovered” americans? How many are illegal seasonal workers? How many are the underemployed? How many are in college? Apparently, no one seems to know where these numbers come from but are sure they’re accurate???? I also inquired about the cost of healthcare, i.e. why is it so expensive to get basic procedures done? Is it to much admimistration? Is the cost of doing business for medical professionals gotten way to high because of things like malpractice insurance? Couldn’t tort reform reduce the administrative costs of healthcare? What happened to the reform act that we passed in the late 90′s? What about interstate competition? And, if you read the new law you’ll discover the vast amount of taxes/fees included that will increase both the private burden and the burden on small and medium busineses, is that really going to equate to more people covered? The law creates so many more issues then is solves, and I haven’t even included the burden it creates on the existing public health care programs (medicare and medicaid), which are very lightly touched in this article, but with some of the most important details left out, like the transfer of billions from them to the new program. Nothing is free here, and frankly imho this law creates more issues then is solves. BTW, I heard this morning that the U.S. gov’t paid millions for a new ad campaign in Mexico, to educate people in that country on how to apply for SNAP (new name for food stamp programs)? WHAT??? We need to vote the incumbants out, hold anyone elected to way higher standards then we have in the past, and start applying some good old commonsense to these issues. When you teach someone it’s easier to rely on others or a gov’t then themselves, you create a entitled population that follows instead of leads.

  15. Logical1 says:

    Yes, more entitlements coming from local and federal statist government bureaucracies that have vividly proven they can’t run the simplest of tasks and who are already bankrupt. Have we learned nothing?

  16. MOCKINGBIRD says:

    Maybe you all don’t know that San Francisco has a city health insurance for the poor and low income. It works extremely well and is cheaper over all because people receive treatment. If San Francisco can do it CALIFORNIA CAN DO IT. IT SAVES MONEY because it keeps people out of the few ERs left with extreme emergencies because of lack of treatment. TREATMENT AND PREVENTION are cheaper and WILL SAVE California money.

  17. Chuck G says:

    No surprise, those who are working and contribute with regularity to paying taxes can expect the same along with more to be taken out of your paychecks

    Those who are not working and expect a handout to survive, along with the corrupt who fake injuries claiming LTD status and the like will continue to bring the state of California down more.

    No wonder people are not only leaving California, but the US in general.

  18. Sarkyfish says:

    A credible journalist would have attempted to explain the costs, but when it comes to reality, PD reporters have been told that realism is off limits.

  19. Enquiring Mind says:

    Where are all the poor people going to live when they flock to Sonoma County for their free health care? Is there a residency requirement?

  20. David Maxwell says:

    Decoded in the Sonoma County liberal enigma machine this translates: We just bought 50,000 democrat votes on the backs of productive people.

  21. Alice Krigel says:

    The bottom line for Sonoma County, already broke because of high end welfare benefits, county pensions and county employee salaries, are much bigger budget deficits for as far as a bureaucrat in denial can see.

    How long will the feds continue to fund MediCal as the newly eligible are enrolled? Right now they are committed out to 2020 but that could change in a vote.

    Obama care could not come on line at a worst time when the feds, many of the states and California in particular are broke. Will the government just keep printing more money to handout to the states? Will the feds just stop payments to the states have they so often do after they pass a mandate?

    This whole thing looks like a giant train wreak just waiting to happen. Too bad we are all on the same train going over the cliff.

  22. Reality Check says:

    “There may be an expanded cost next year in the level of contribution we make.”

    That was the last sentence in the article, and the last thing that mattered apparently to Martin Espinoza, who wrote the article.

    Look, the problem is serious and deserves a fix. But happy talk devoid of any candor about cost or alternatives (and there are) is irresponsible. And it’s also why Sonoma County government has chronic budget problems.

    The so-called working poor can’t afford medical insurance, in part at least, because the Feds and Calif have mandated everyone have a Cadillac policy. Better, so the thinking goes, to have no policy than a pure high deductible one, or maybe, better yet, to drive everyone to the only alternative left, a government takeover of health care.