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Sonoma County says its ready for health care changes

By MARTIN ESPINOZA
THE PRESS DEMOCRAT

At least 25,500 uninsured Sonoma County residents are expected to get health insurance by the end of the first year of full implementation of President Obama’s health care law, county health officials say.

The figure represents 36 percent of the 70,000 county residents who have no health insurance. About 20,000 county residents will not be eligible for expanded health coverage because of their undocumented immigrant status.

Health careDuring the Board of Supervisors meeting this week, county health and human services officials summarized steps the county has been taking to prepare for the last stages of the health care law, commonly known as Obamacare. Officials assured supervisors that the county is ready for what could be an unprecedented sudden wave of newly insured residents.

“We do believe we are ready,” said Rita Scardaci, director of the Sonoma County Department of Health Services. “This is the beginning and it’s always good to start on a strong foot.”

The final components of the law take effect Jan. 1, 2014, including a massive expansion of the federal Medicaid program, known in California as Medi-Cal, and the so-called individual mandate, a requirement that most people obtain health insurance or pay a penalty.

An even more timely deadline is just three weeks away, when the state launches its Covered California health insurance marketplace. Open enrollment for Covered California begins Oct. 1 and runs through March 31, 2014.

A new coalition of local health care professionals, known as Covered Sonoma County, is expected to spearhead efforts to get people enrolled. The coalition includes employees at community health centers, hospitals, health insurance groups and county health and human services departments.

Scardaci said that an estimated 18,000 Sonoma County residents will become eligible under an expanded Medi-Cal program. The cut-off for Medi-Cal eligibility is now set at 138 percent of the federal poverty guideline. It was previously 100 percent of the poverty level.

The coalition has set a goal of getting 13,500 new Medi-Cal residents insured by Dec. 31, 2014, Scardaci said. Also, by that date an additional 12,000 local residents are expected to become insured through Covered California, which will offer subsidized health plans on a sliding scale for those making from 139 percent to 400 percent of the poverty line.

According to Covered California, a family of four with an annual household income of $31,900 could potentially receive an $11,100 tax credit toward the family’s $12,300 annual premium. In such a case, the monthly premium is $100.

For a family of four earning $88,800, the annual federal subsidy would be $3,900 for a monthly premium of $700 a month.

During the Board of Supervisors meeting, county risk manager Marcia Chadbourne briefed supervisors on the impact the new health care law will have on the county as an employer.

Chadbourne said the provision in the law that requires large employers to provide health insurance to at least 95 percent of their employees — known as the employer mandate — had been postponed until 2015. She said the county government already meets that requirement.

But another provision of the law that would levy an excise tax on “Cadillac” health plans could cost the county $4.1 million by the time the provision takes effect in 2018.

“Our goal is to work with labor organizations to align our health plans with the Affordable Care Act requirements to minimize or avoid excise taxes,” Chadbourne said.

A majority of county employees, about 2,700, are covered by Kaiser health plans that do not meet the “Cadillac” threshold and therefore trigger no tax, she said. But some of the county’s higher wage earners are covered by the county’s “self-insured” health plan, which qualifies as a Cadillac plan.

Several supervisors expressed concern about the $4.1 million excise tax and encouraged county staff to figure out ways to minimize the financial impact, which could involve negotiating a reduction in benefit levels.

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





15 Responses to “Sonoma County says its ready for health care changes”

  1. storm chaser says:

    the affordable care act should really be called the non-affordable care act due to its lack of people not acknowledging the fact that there is going to be 20 more laws enforced upon the Obama care being enforced and causing an even bigger debt for us brave Americans, due to the laws being poorly written and poorly read; we,Americans, need to get rid of our ignorance and step up our game, and not be so lazy.
    Im sorry for my rage, and i know about the deficit, fore i suffer from it as well, but we need to stay strong and suffer through the next 8 years with low pay and hard work and it surly will pay off.
    thank you, and god bless

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  2. Emerson Burkett says:

    To “Follower”,
    If you think that I am an unthinking trust-er of Government; then you have not “followed” my previous postings on this site. And RE, “…can’t blame you for your ignorance.” “…gin up the name calling”.

    Thumb up 3 Thumb down 3

  3. MOCKINGBIRD says:

    Larry Watkins, the Affordable Care Act is as far from socialism as you can get. It contracts with for-profit insurance companies who will make out like bandits and will cost too much for the people who will be paying that profit. With copays, deductibles and premiums along with a nice profit margin for the corporate insurance companies and cut benefits it will not do the job. We should have expanded Medicare or contracted with Kaiser Permanente and other NON PROFIT groups who will roll their profits back into patient care. Now that’s socialism that will work for everyone.

    I’d like a real socialistic health insurance coming out of our taxes like SOcial Security based on our incomes and is equal for all. One that focuses on well care and preventative care, catching illnesses early and keeping people out of the very expensive to the tax payers Emergency rooms.

    With capitalism a little socialism equals things out for workers and their families.

    Thumb up 5 Thumb down 3

  4. Liz says:

    My proof to Obamacare being a very bad plan is from personal experience.

    Both my Blue shield and my husbands Kaiser have gone up in cost, 2 times each in the last year. Both times from both insurance companies we got a letter stating the reason for the cost increase was because of all the costs and things associated with obamacare, or the ACA as they worded it (affordable care act).

    Also I have had older family members go into the doctors for care and they were told we can not help you even though it is treatable. It is due to age and again the ACA.

    These are just facts I am personally dealing with. So because of this I don’t see how obamacare is of any help to the people of this country.

    When you have union leaders now asking to be exempt from this law something is wrong. They were big proponents of it in the first place.

    And yes as Emerson said it is far from perfect. But this is no way to start something. If you start so far from perfect you have no way to guarantee that it will turn out successful in the end. It needs to start out by addressing the real problem, and that is cost. Obamacare does nothing to address cost and only has guaranteed my costs to keep going up. And for a middle class person I can’t afford that. I want real solutions please.

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  5. Larry Watkins says:

    If Obama careless is so great, how come no Congressional Republicans voted for it? If it is so great, why will be result in vast employee hourly cutbacks and pay cuts? If it is so great, why is it costing so much and cutting coverage for so many who have good health insurance?

    These are just some of the questions the Obama plan had to pass before we could know what was in it and how much it would cost. Would any of you buy something that you didn’t know the price and how it would benefit you and your family? Not many.

    A very bad system being forced down our throats by a socialist president and his minions.

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  6. Follower says:

    @Emerson Burkett
    I couldn’t disagree more.

    In my view, the “main cause of problems in this country” are people who hold our Constitution in contempt.
    Our Founders didn’t omit Health Care from the Bill of Rights because they didn’t have Doctors back then or because they simply forgot!

    I understand completely how someone could live their entire lives seeing only the “good” that Government does because Government DOES DO a lot of “good”. Were I one of those people I may believe that having the IRS between me & my doctor is a “good idea” too.

    But I have seen with my own two eyes the fiscal waste and abuse of power that ALWAYS happens on the road of good Governmental intentions.

    Apparently you haven’t. I can’t blame you for your ignorance.

    If I could hold just ONE major Government Agency in high regard for their honesty, productivity, fiscal management and responsible use of the power we give them “I” may hold some “hope” for the “change” that is coming to my Doctor/Patient experience.

    So if you know something I don’t, please enlighten me.

    Just what major Government Bureaucracy has so impressed you with their efficiency, professionalism and sincere dedication to quality customer service that the thought of them running your Heath Care sends a tingle up your leg.

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  7. Emerson Burkett says:

    Well said and true, Dan Drummond Sr. “It could be a better system…Republican/Tea Partiers don’t seem up to the challenge.” AKA Wingnuts. We are the only Industrialized nation, in the world without some form of Universal Healthcare; or, rather, we were before Obamacare. And yes, it is far from perfect, but a few steps in the right direction. That is how I see it, so gin up the name-calling if you wish.

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  8. Emerson Burkett says:

    The main cause of problems in this country is WINGNUTS of both the Right and Left. Although, at the present the WINGNUT RIGHTIES seem to be much more prevalent. Sorry, but, Obamacare is not all those scary things that Righty Wingnuts claim it is. In fact, the concept was originally a Conservative idea and was first put in place by Mitt Romney, when he was Governor of Mass. But, wingnuts never want to hear or believe the truth.

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  9. bear says:

    I really hope that no one here is ever confronted with a major health crisis in your family.

    The problem with “Obamacare” is that it will NOT protect you from the greed of insurance companies.

    Maybe someone in your family (wife, child?) needs to die before your eyes – even when covered by health insurance that denies reasonable claims.

    No charge for denial of treatment, even if the circumstances are immediate and critical.

    I’ve been there.

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  10. Dan Drummond Sr says:

    In three and a half months the United States of America will finally have a universal health care system! It could be a better system, but at least we have one, like thirty-two other nations. Now it’s up to Congress to make it a world class system. That may take awhile, because the Republican/Tea Partiers don’t seem to be up to the challenge.

    Thumb up 7 Thumb down 15

  11. James Bennett says:

    Obamacare is evil.

    A listing all of it’s dark baggage would be much longer than this propaganda piece.

    Including, crashing business and families; as intended.

    Mandatory chipping and vaccinating.

    God help us.

    I need a tall glass of wine…

    Thumb up 16 Thumb down 12

  12. Reality Check says:

    Of course most people can afford to pay for their medical care. True, most of us can’t afford a catastrophic medical bill, but routine and ordinary stuff, yes. Most of us need a catastrophic care plan and the willpower necessary to save enough to for the deductible.

    Heck, most Americans spend all kinds of money on discretionary luxuries and think nothing of it. Stand outside of Costco or Target and see what stuff comes out the door.

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  13. Follower says:

    @Bear
    Instead of asking “why does a Q-Tip cost $10.00”, you just accept that a Q-Tip costs $10.00 despite the fact that you know better.

    This is what’s wrong with Obamacare.

    It not only does NOTHING to address the REASON FOR exponentially expanding Health Care costs, it makes sure costs will continue to escalate beyond the reach of any mortal human by using the Federal Printing Press to assure that no matter how much they charge you for that Q-Tip, there will be an infinite pool of money to pay for it.

    5 years from now that same $10.00 Q-tip will cost $50.00

    You’re “leaders” aren’t doing this because they’re stupid. They’re doing it because they know that everyone will eventually need Health Care and if nobody can afford it, they will have NO CHOICE but to depend on the Government to pay for it.

    Now they gotcha!

    The more dependant you are for Government assistance, the less likely you are to vote for those evil Republicans promising to make you pay for it yourself.

    And since the inept Republican “leadership” has failed so miserably to explain how their way not only reigns in these costs but makes it much easier for you to accumulate the wealth needed to afford it, you support Socialism.

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  14. bear says:

    Who do you think pays $10 for a Q-tip or a toothbrush at a hospital?

    Answer: those who already have health insurance. We pay your welfare claims.

    Can anyone here pay for their healthcare?

    Surprise me, you closet socialists.

    Thumb up 10 Thumb down 21

  15. brown act jack says:

    Tax credits are funds that are taken from other tax payers to cover the costs covered by the tax credits.

    In effect, you are taxing the other taxpayers to pay for the medical coverage of the other parties.

    And how many of the doctors are going to be willing to accept Medi-Cal patients due to the low payments to the doctor.

    Oh,and the un-insured immigrants will still get free care at the emergency room, which , of course is paid for by the tax payers, one way or the other,
    right!

    $12,500 a year premium for a family is more than the minimum wage, or very close to it.

    How do they expect the minimum wage workers to live?

    It is a tax credit, is it not? And do minimum wage workers pay income tax?

    And when do they receive the tax credit if it is a refund?

    Social , something or the other, I guess.

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