San Diego County Health Care Benefit Rules Overturned
A three-judge panel of a state appeals court on Wednesday ruled that San Diego County is violating state law by denying medical care to county residents whose incomes exceed eligibility guidelines for a county health care benefit but cannot afford private coverage, the San Diego Union-Tribune reports (Clark, San Diego Union-Tribune, 5/24).
A San Diego Superior Court judge in November 2005 ordered the county to restructure its formula for determining thresholds for the County Medical Services program while considering a resident's ability to pay for medical costs.
The county Board of Supervisors in December 2005 approved new eligibility thresholds: $1,078 per month for an individual and $1,445 per month for a two-person household. Residents who work are allowed to earn an additional $90 (California Healthline, 4/13).
However, plaintiffs' attorneys argued that the new income thresholds for the County Medical Services benefit were too high for low-income residents in a high-priced county.
Counties are required under state law to pay medical bills for indigent residents with severe illnesses.
Attorneys from the Western Center on Law and Poverty argued that if the county complies with state law, low-income residents whose incomes surpass a monthly limit could qualify for the benefit by paying the cost difference.
The attorneys also said that the county could develop a sliding-fee scale, raise the monthly income limit or make other arrangements. Each of those options could cost millions of dollars each year, according to the Union-Tribune.
The county Board of Supervisors could appeal the decision to the state Supreme Court, a process that could take at least one year to resolve (San Diego Union-Tribune, 5/24).