Health & Medicine

Changes could mean loss of health insurance for Sacramento County’s poor

More than 13,000 low-income people face the possibility of losing their health insurance under a policy approved by Sacramento County supervisors this week, although county officials say very few will reach that point.

Supervisors voted 5-0 to remove people from the County Medically Indigent Services Program, or CMISP, if they are eligible for other coverage and don’t apply for it. No one spoke against the proposal at Tuesday’s board meeting.

The policy was approved as the subsidized health care exchange Covered California begins enrolling participants next week under the federal Affordable Care Act. The national overhaul has extended health coverage to previously uninsured individuals through a Medi-Cal expansion and Covered California.

Sacramento County intends to largely phase out CMISP, its last-resort coverage for the poor, as a way to save money and shift health care costs to state and federal governments. By April 1, the county expects all but 700 of 14,000 CMISP participants to be enrolled in Medi-Cal or Covered California.

Under the policy approved by county supervisors, CMISP participants will have a one-year grace period in which they can still access county health care even if they fail to enroll in other programs for which they are now eligible. The policy also includes a clause that precludes removal from CMISP when a participant has a “hardship situation.”

“We would expect the number (of people losing coverage) to be very low,” said county Health and Human Services Director Sherri Heller.

The county is sending notices of the policy change to CMISP recipients. Many of them are homeless, and the notices are being sent to a general post office box serving the area’s homeless, county spokeswoman Chris Andis said. Notices are also being posted in the county’s Department of Human Assistance building on 28th Street and its Primary Care Facility.

The larger shift in responsibility for low-income health care has prompted some financial concerns. With the state taking greater responsibility of these services, it expects to cut $9.2 million of the $41 million previously budgeted to the county for low-income health care.

If everyone transitions to new coverage as planned, the county won’t lose money, but Heller and other officials have expressed some skepticism about the state’s projections.

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