County Officials Say ACA Could Negatively Affect Safety-Net Funding

County health officials say the Affordable Care Act could threaten the financial stability of safety-net health care providers in California, the Los Angeles Times reports.

Background

Experts estimate that about three to four million individuals -- about 10% of the stateâs population -- will remain uninsured after implementation of the ACA.

Health care providers that will serve such individuals include:

Public hospitals;
County health centers; and
Community clinics.

Financial Challenges for Safety-Net Facilities

According to county health leaders, patients who obtain insurance under the ACA will no longer visit safety-net facilities, leading to a loss in revenue for such providers.

In addition, federal funding for safety-net hospitals is set to decrease under the ACA, observers say.

County officials also say the facilities could lose money under proposals by Gov. Jerry Brown (D) to take funding from counties and use it to expand Medi-Cal under the ACA. Medi-Cal is California's Medicaid program.

Comments From County Officials

Lucien Wilson, director of the Insure the Uninsured Project, said, "Safety-net providers are imperative ... and some of their funding streams are in serious danger."

Mitch Katz -- director of the Los Angeles County Department of Health Services -- said that state proposals to take money from counties for the Medi-Cal expansion are "completely unreasonable."

Alex Briscoe -- director of the Alameda County Health Care Services Agency -- said such proposals show a "fundamental misunderstanding" of the pressures that safety-net facilities face. Noting that about 100,000 residents of Alameda County could remain uninsured after implementation of the ACA, he asked, "If the state takes the money, who is going to pay [for]Â that care?"

County leaders also say that the state should not take money that would aid safety-net facilities to pay for the Medi-Cal expansion because the initiative is fully paid for by the federal government for the next several years.

State Official Responds

Responding to criticisms about redirecting funds to aid the Medi-Cal expansion, Toby Douglas -- director of the state Department of Health Care Services -- said, "There is going to be a fundamental shift in responsibility of health care to the state from the counties," adding, "There needs to be a realignment of county dollars" (Gorman, Los Angeles Times, 2/25). This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.