Health Reform Doing the Right Thing ?

A leader on health care reform, Alameda County could get penalized for doing too much

By Matt O'Brien

     The Affordable Care Act will do little to decrease health care costs overall, and early analysis shows that premiums have risen as well as deductibles.  This will reduce markedly the amount of disposable income for families, and  businesses.  Those who can afford 'premium' insurance policies will be penalized by a tax specified in the Affordable Care Act. 

Reducing disposable income effectively impacts other areas of the GDP (Gross Domestic Product), thereby increasing the relative amount that healthcare contributes to the GDP.  At the moment health care spending amounts to 16%,  or 1/6th  of the entire economy.

The Contra Costa Times reports:

 Long before President Barack Obama made universal health coverage a national priority, Alameda County earned accolades with its mission to ensure decent medical care for all its nearly 1.5 million residents. A tax hike approved by voters a decade ago fortified an expansive safety net of public hospitals and primary care clinics.

So why are local health leaders so worried as the new federal law takes effect in January? An arcane state funding formula, they say, will soon penalize the county for its commitment to treating everyone, including the poor and immigrants denied health insurance because they are in the country illegally.

An arcane state funding formula will soon penalize the county for its commitment to treating everyone, including the poor and immigrants denied health insurance because they are in the country illegally.

A liberal Bay Area county that positioned itself as one of Obamacare's California standard-bearers, beating out most others in laying the groundwork and pre-enrolling the poor, is now running into problems because of its generosity.  But that voter and taxpayer contribution is counting against Alameda County as the state is about to take away $11 million in health care funds and could grab more than $30 million in the coming fiscal year. The cuts are based on the state's expectation -- Briscoe says an overly rosy one -- that expanding federal benefits will lessen the burden on urban hospitals and nonprofit clinics because more people will qualify for free or low-cost care through Medi-Cal.  

Since 1991, state health care funding has been channeled into counties from a pot of state sales tax revenue and vehicle license fees. But Gov. Jerry Brown signed a law in June that orders counties to cough up 60 percent of their annual allotment or submit to a complicated formula that puts Alameda County at a disadvantage.

The state's reasoning is that the growing population of insured patients will be a boon to medical providers. Yet local providers anticipate about 150,000 Alameda County residents will remain uninsured because they do not or cannot sign up for Covered California, the state's version of the new federal health exchange. As many as 60,000 are immigrants without documentation whom the county is determined to keep caring for despite their exclusion, by law, from signing up for health insurance. Alameda County's mission to leave no one untreated contrasts with counties such as neighboring Contra Costa, which explicitly denies county-supported care to immigrants here illegally.

Alameda County in California has some unique features about their Safety Net. The California HealthCare  Safety Net prepared an award ground breaking documentary, "TheWaiting Room" putsa spotlight onpatients and public hospitals in California.