Eligibility Rules for San Diego County Health Care Program Challenged
On Tuesday, 17 plaintiffs filed a motion challenging new eligibility guidelines for San Diego County's program to provide medical assistance to indigent patients, asking that the rules be reworked further, the Los Angeles Daily Journal reports.
The new guidelines for the County Medical Services program stem from a ruling that directed the county to expand eligibility for the program.
The 4th District Court of Appeals in May 2007 rejected an earlier version of the county's no-cost health program because it said the income eligibility cap was inflexible and excluded residents who could not afford care.
The appellate court's ruling reversed the San Diego County Superior Court judge's approval of the county's original standards (George, Los Angeles Daily Journal, 3/5).
The new guidelines open the program to county residents whose incomes do not exceed 165% of the federal poverty level but permit residents whose incomes exceed that amount to apply for hardship exemptions.
In addition, the guidelines require copayments for patients whose incomes fall between 135% and 165% of the poverty level (California Healthline, 12/3/07).
Since January, 194 county residents have applied for waivers, but only one waiver has been granted.
Critics argue that the waiver process is unnecessarily complicated, citing extensive paperwork requirements and a 10-day deadline.
Timothy Barry, a senior deputy attorney defending the program for the county counsel, said San Diego County carefully developed a formula for calculating how much patients could afford for health care, based on food, travel and other costs of living in the county.
On March 28, San Diego Superior Court Judge Ronald Styn will decide whether the program meets the legal requirements established by the previous decisions. Styn also will decide how the county should reimburse residents who were wrongly denied medical assistance in the past (Los Angeles Daily Journal, 3/5).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.