San Diego County Income Limits for Medical Care Violate State Law, Judge Says
San Diego County must stop using income limits that disqualify low-income residents for last-resort medical care at no cost because the limits violate state law, Judge Ronald Styn said in a tentative decision on Thursday, the San Diego Union-Tribune reports. The decision is expected to be confirmed on Friday (Clark, San Diego Union-Tribune, 11/18).
San Diego County Medical Services provides coverage to county residents whose incomes do not exceed certain levels, currently $802 monthly for an individual or $1,084 monthly for two people, excluding some deductions. Only Orange and San Diego counties in California do not offer cost-sharing options for uninsured residents whose incomes exceed the thresholds (California Healthline, 9/6).
Styn said state law requires County Medical Services to provide medical care for life-threatening conditions based on each patient's ability to pay. In the tentative ruling, Styn said the county must reimburse medical costs for patients denied County Medical Services benefits in the past two years. In addition, Styn said the county will have 60 days to establish a new eligibility policy and 90 days to implement a new policy.
County attorneys are expected to challenge the tentative ruling in a hearing on Friday, but lawyers said judges traditionally do not change tentative rulings.
County officials on Thursday recommended increasing income thresholds to $1,078 for an individual and $1,445 for a two-person household, which would make 1,800 more residents eligible for County Medical Services benefits.
County Medical Services official Vicki Mizel said the proposed changes would increase the cost to the county by $6.2 million.
However, critics of the proposal noted that it doesn't contain a "share of cost" provision.
The proposal will be reviewed by the county Board of Supervisors on Dec. 6 (San Diego Union-Tribune, 11/18).