Plan Could Extend Health Coverage to Thousands

Gilroy
– While pundits debate the governor’s mandatory, multi-billion
health care proposal, county organizations have cooked up a
voluntary coverage plan to keep Santa Clara County workers
healthy.
Gilroy – While pundits debate the governor’s mandatory, multi-billion health care proposal, county organizations have cooked up a voluntary coverage plan to keep Santa Clara County workers healthy.

It’s called Valley Care, and if county supervisors OK the plan, it could extend health coverage to more than 25,000 uninsured workers, in more than 14,000 small businesses countywide.

“We need to figure out how to expand health care coverage to low-income, working adults,” said Sarah Muller of Working Partnerships USA, a San Jose-based research and policy organization helping to develop the plan. “This is a logical next step.”

Small businesses are struggling to provide health coverage to their employees, according to the California Chamber of Commerce, with premiums rising at triple the rate of larger firms. Meanwhile, roughly two-thirds of the state’s uninsured are full-time workers and their dependents. Muller called small businesses “a clear target” for increased health care coverage.

Through the voluntary three-pronged plan, small businesses and their employees pitch in for discounted health coverage, offered by the Santa Clara Valley Health and Hospital System. Businesses with fewer than 50 employees would pay a monthly premium, ranging from $125 to $150, said Muller; very small businesses, of fewer than 10 employees, might be able to waive the premium. Workers might pay $50 or less per month, on a sliding scale, but the details are still being worked out.

Enrolled employees could go to Valley Medical Center, any county or community clinics, or any private provider under contract with the county. And unlike commercial plans, said Muller, Valley Care will be both affordable and comprehensive, at roughly half the price of a comprehensive commercial plan.

It could even save the hospital system money, said Muller, by pumping funds from workers and employers into SCVHHS.

“Right now they treat roughly 90 percent of the uninsured in the county,” she explained, “and they receive very little revenue for those services.”

The plan was first presented to county supervisors in November, and was given a positive recommendation by its Health and Hospital Committee Feb. 14. Now, the plan’s proponents are ironing out the details before the idea is discussed by the full board of supervisors March 20.

City councilman Roland Velasco, who works as a policy aide for county supervisor Don Gage, noted the plan’s limitations.

“The coverage plan is very limited in scope, and it’s a very small population that we’re talking about,” he explained. “Plus, employees can only be served in Santa Clara County. So if you’ve got the coverage plan but you’re injured in Fresno, you can’t go to a Fresno hospital.”

And as currently imagined, Valley Care has an income cap, a downside according to Gilroy Chamber of Commerce president Susan Valenta. Valenta has been researching health coverage for her ‘President’s Message’ on the subject.

“If an individual has to have a certain income level to qualify, that doesn’t really solve the problem,” she said. “Some of California’s uninsured make over $50,000 … The cost of living is very expensive in Silicon Valley, and that monthly premium might prevent them from making a mortgage payment.”

But Valenta prefers the plan to that proposed by Gov. Arnold Schwarzenegger, mainly because it’s voluntary.

“The answer isn’t going to be a mandate,” she said.

Worries about the plan “are generally coming from businesses that couldn’t afford to take on any additional costs, even $100 a month,” said Muller. The solution is simple. “We anticipate that they wouldn’t take up the program.”

Analysts predict that the program, estimated to cost $20 million annually, won’t dip into the county’s general fund. Instead, the program will distribute costs between employers, employees and SCVHHS, which provides the discounted plans.

If the governor’s plan passes, it might alter the Valley Care plan, but exactly how remains to be seen.

“The governor’s proposal includes an employer mandate, which would target many of the same employees we’d target through this program,” said Muller. However, “his plan is specifically targeted at private insurance companies,” while Valley Care uses public clinics.

“This is fundamentally different,” Muller said, “than anything in the market today.”

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