Ventura County Supervisors Propose Extending County HMO

The Ventura County Board of Supervisors will consider extending the county's HMO to private businesses that currently do not provide health insurance, a move that could "trigger new conflict" between the county and Community Memorial Hospital, the Los Angeles Times reports. Proposing the plan at a recent board meeting, Supervisor Frank Schillo said that he envisions "a system in which employers and low-wage employees could share the cost of rates as set by the county." Under the plan, the county would insure workers who do not receive health insurance through their employer and who earn too much to qualify for state or federal insurance programs but cannot afford private insurance. The Ventura County Living Wage Coalition estimates that between 96,000 and 170,000 county residents fall into this category. Schillo said, "The county is responsible for the health net of the citizens of the county." However, Community Memorial Hospital and other private-sector critics claim that by extending its HMO, the county is trying to compete with private firms. Community Memorial has opposed the county HMO since its creation in 1994, when the hospital unsuccessfully sued the county, saying it was "improperly" competing with the private sector by diverting county employees who would otherwise have visited private doctors and hospitals. But Schillo insisted that the county is "not interested in being in competition with private business" and would only deal with businesses that "already have ruled out providing private insurance altogether." Schillo added that the proposal would have to be carried out "very carefully and with the support of commercial (insurance) carriers."

Critics also suspect that the Board of Supervisors hopes to divert tobacco settlement funds to the county by expanding its HMO, especially following the defeat of Measure O (Talev, Los Angeles Times, 12/5). County voters on Nov. 7 "overwhelmingly rejected" Measure O, the Community Memorial Hospital-sponsored ballot initiative that would have diverted the county's $260 million tobacco settlement to private hospitals (California Healthline, 11/8). Instead, the money will be allocated for a variety of health programs, such as antismoking campaigns, mental health and dental services and disease prevention programs (California Healthline, 11/9). Jim Lott, vice president of the Health Care Association of Southern California, said, "If this is an insurance program that allows people to go where they want to go for health care, it would be a good venture. If this is structured as a way to divert all the tobacco money to the county, we're right back to square one and it's World War III." Schillo responded that the county does not plan to use tobacco settlement funds to subsidize coverage, and believes basic coverage offered through the county HMO would cost "much less money than private insurers charge using private doctors and hospitals." Meanwhile, the county has asked CAO Harry Hufford to look into the expansion proposal, which, according to Hufford, could take several months of study (Los Angeles Times, 12/5).