About 40,000 Low-Income San Mateo County Residents May Face Restricted Access to Physicians
About 40,000 San Mateo County residents enrolled in Medi-Cal, Healthy Families and the county's Healthy Kids and Well programs will have fewer choices of doctors if the state and federal governments do not intervene to halt the Health Plan of San Mateo's expected bankruptcy in October, according to the Bay City News Report. County officials on Friday said reduced reimbursement rates and rising medical costs have kept the health plan on the verge of bankruptcy for two years. According to the News Report, the health's plans reserves will fall below the legal limit and force the plan to close by the end of October. County Manager John Maltbie said, "None of those people will lose their health coverage because the state still has the obligation to fund [these] program[s]." He added that the state would have to provide the required services "in a different way." Maltbie said if the health plan does go bankrupt, the state will take over the Medi-Cal program, and beneficiaries will have fewer choices of doctors and could be forced to seek routine care in emergency rooms, according to the News Report.
In January, the county agreed to a contract with the state that would have transferred $8 million in state funds to the health plan. However, the federal government ruled that an intergovernmental transfer of funds was not appropriate. According to the News Report, Rep. Anna Eshoo (D-Calif.) is "pushing" for Michael Murray, the health plan's director, and CMS Administrator Tom Scully to find a way to prevent closure of the plan, but county Supervisor Richard Gordon said last week it will take a "miracle" for the plan to remain open. "It's going to take some level of state and federal intervention that I think will be difficult to achieve," Gordon said. Without any state or federal intervention, the health plan is scheduled to notify its beneficiaries of its closure beginning Sept. 1 and will begin a six-month, $10 million process of shutting down, Gordon said (Bay City News Report, 8/2). The Bay City News Report did not address the anticipated effects on Healthy Families, Healthy Kids and Well beneficiaries resulting from the expected health plan closure.
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