Health Reform Law To Have Mixed Effect on California Counties

The effect of the new health reform law on California counties will depend partially on how the measures are implemented and which social services counties choose to administer, PublicCEO reports.

Health Insurance Exchanges

Counties are likely to experience significant changes resulting from the reform law's establishment of health insurance exchanges.

Micah Weinberg, senior research fellow at the New American Foundation, said the exchanges will either simplify the health insurance purchasing process or add another level of bureaucracy and complication, which could lead to higher costs.

One way the exchanges could affect counties is by taking over the process of overseeing enrollment for Medi-Cal, California's Medicaid program.

Details about county involvement in an expanded Medicaid program remain unclear, but the reform law specifically states that counties will not be required to contribute a larger percentage of the non-federal share of Medicaid than they provided in 2009 (Long, PublicCEO, 6/21).

Other Effects on Counties

Although declining tax revenues have forced many counties to cut back on in-home care for elderly residents and other services, the new reform law is expected to help cover many of these services (Sepulvado, "KXJZ News," Capital Public Radio, 6/21).

In addition, the reform law is expected to provide counties with more funding for community health centers and access to billions of dollars in competitive Community Transformation Grants.

However, counties are expected to lose federal funds from Medicaid Disproportionate Share Hospital Payments as the reform law extends insurance coverage to more residents (PublicCEO, 6/21).