2012-07-06 / Front Page
Supreme Court ruling impacts county’s healthcare agency
AFFORDABLE CARE ACT
Ventura County healthcare officials estimate 50,000 county residents will become eligible for state-sponsored healthcare coverage after last week’s Supreme Court ruling upholding President Barack Obama’s Affordable Care Act of 2010.
The June 28 ruling declared Obama’s signature healthcare reform law constitutional and added that individual states could decide whether they want to participate in the optional expansion of Medicaid—the federal health insurance program for no- or low-income residents.
In California, the Medicaid program is managed through Medi-Cal, also known as the Gold Coast Health Plan.
Bob Gonzalez, medical director of the Ventura County Health Care Agency, said there are about 101,000 county residents currently enrolled in Medi-Cal, whose incomes fall under 100 percent of the federal poverty level.
“Residents now will have to be under 133 percent of the poverty level to receive Medi-Cal in this new expansion,” Gonzalez said. “This picks up all the people who are between 100 and 133 percent, who weren’t eligible before.”
Under the Affordable Care Act, parents with employee-sponsored health insurance can continue covering their children through age 26. Insurance providers cannot disqualify individuals from receiving coverage because of pre-existing medical conditions or place lifetime caps on total medical expenses.
Medi-Cal coverage was formerly reserved for no- or low-income individuals with a dependent child in the home or people with serious disabilities.
But the new expansion removes that requirement, Gonzalez said.
“It helps provide medical coverage for people who are, for example, 40 to 50 years old, who are not yet eligible for Medicare and might have chronic illnesses but no dependent children,” he said.
The Ventura County Health Care Agency provides care to Medi-Cal recipients through the Ventura County Medical Center, Santa Paula Hospital and other participating clinics.
“What has happened is the systems that do deal with Medi-Cal patients and the uninsured are in the process of making changes to accommodate the increased need for access,” Gonzalez said.
The Ventura County clinic system is now making plans to expand medical clinics in Oxnard, Thousand Oaks and Moorpark, he said.
Although the expansion means more patients in public clinics and hospitals, Gonzalez said it will actually cost taxpayers less.
“When patients are uninsured they tend to come in late with their medical problems,” he said. “We lose the opportunity to make diagnoses earlier. They often wait until they’re sick, then go to the emergency room, which costs five times more than going to a doctor or clinic.”
Newly eligible residents will instead be able to get earlier treatment for diseases, as well as free preventive care like child immunizations and mammograms.
As part of last week’s ruling, the Supreme Court upheld the Affordable Care Act mandate that requires Americans to buy health insurance or pay a penalty.
Although the court ruled 5 to 4 that the mandate is unconstitutional under the U.S. Constitution’s commerce clause, it also decided the requirement could stay in place under Congress’ power to impose taxes.
Therefore, those who do not buy insurance may be legally taxed.
While the president and Ventura County health officials consider the Supreme Court ruling a victory, the decision has spawned criticism from some local politicians.
U.S. Rep. Elton Gallegly (RCamarillo), who represents the 24th Congressional District that includes Ventura County, said in a statement that the ruling exposes the president’s “predisposition to tax the American people to pay for big government programs that kill jobs and place unreasonable burdens on all Americans.
“But just as Congress can tax, it can repeal taxes,” the congressman said.
Gallegly, who is retiring at the end of his term this year, said he will continue working to rescind the reform law.
“Then Congress can take a strong look at the health insurance system and our overall healthcare system, analyze where it can be made more efficient and responsive to patients and healthcare professionals, and take the steps necessary to make it more accessible and affordable for all Americans without big government taxes.”