Lawsuit on Indigent Care in San Diego County Begins Friday
A case to be heard beginning Friday in San Diego Superior Court could lead to the county being required to provide health care coverage for "thousands" of low-income county residents, the San Diego Union-Tribune reports. The hearing is part of a class-action lawsuit filed by eight plaintiffs against San Diego County Medical Services over allegations that they were illegally denied medical services because their incomes exceeded the county eligibility level for indigent care (Clark, San Diego Union-Tribune, 5/5).
In San Diego County, low-income uninsured residents whose monthly incomes exceed $802 can receive coverage for emergency care under County Medical Services. The program serves 22,000 county residents annually at a cost of more than $60 million.
The lawsuit seeks coverage of medical care for the plaintiffs and an order to prevent the denial of such coverage to other county residents in similar cases. The lawsuit does not seek monetary damages but requests reimbursement for medical costs paid by the plaintiffs (California Healthline, 1/25).
Only two California counties -- San Diego and Orange -- do not offer a cost-sharing option for indigent health care. Such an option would allow uninsured patients whose incomes exceed program guidelines to pay a premium to the program and receive health care coverage.
San Diego County officials said 3,860 of 16,225 applications to County Medical Services were rejected in 2004. In addition, 1,217 residents were dropped from the program because their year-long eligibility expired.
The county annually provides $15 million from tobacco settlement funds to County Medical Services, but "other revenue sources have dried up," according to the Union-Tribune. In the next several weeks, the hospital portion of the fund is expected to run out of money, with hospitals expected to absorb some treatments costs.
Some physicians and hospitals are opposed to broadening County Medical Services eligibility criteria because of concerns that the county would not increase funding for the program.
Sharp Healthcare CEO Michael Murphy said, "The pool of funding needs to increase first," adding, "We certainly believe ... the priority here has not been health care, and that's a cost shift to employers."
Robert Ross, president of the California Endowment and former San Diego County health director, said, "There's no question that San Diego County government has historically spent less money per capita on the health safety net than most sizable California counties."
Ross added that the situation is part of "the slow meltdown of our health care system." He said, "In my view, San Diego County is the canary in the mine on health care nationally."
County HHS Secretary Jean Shepard said, "San Diego County taxpayers have spent close to $300 million to provide health care services to indigent adults in the last five years." Shepard indicated that the federal government has not adequately addressed the issue of the uninsured and underinsured, the Union-Tribune reports.
Katie Murphy, the plaintiffs' lead attorney from the Western Center on Law and Poverty, said, "We're not talking about giving health coverage to Donald Trump. How can the county think someone at this income level can pay for food, clothing, shelter as well as necessary surgery, dialysis and chemotherapy?" (San Diego Union-Tribune, 5/5).