Sonoma County to extend health coverage to undocumented residents

Sonoma County next year will begin offering basic medical coverage to thousands of adult undocumented immigrants, a move aimed at providing health services to those who do not qualify for such coverage under President Barack Obama’s Affordable Care Act.

The new initiative represents another significant shift in medical coverage for the uninsured, coming in the wake of Obamacare and a state deal last month to offer health coverage to undocumented children.

The latest move comes in the form of a two-year pilot program offered by a 35-county consortium that pools money to pay for health insurance for the indigent. Sonoma County is one of the largest members of the consortium, called the County Medical Services Program, or CMSP.

It’s unclear exactly how many undocumented immigrants could seek health coverage through the program. There are about 20,000 uninsured people in Sonoma County, many of them believed to be undocumented immigrants.

Recipients will be offered “limited scope” primary care benefits and access to prescription drugs up to $1,000, said Rita Scardaci, director of the county’s Department of Health Services and a member of the CMSP governing board, which approved the pilot program at its June 28 meeting.

Scardaci hailed the decision last week, touting a safety-net expansion she and others said would benefit another group of the uninsured.

“This is really an amazing step forward to provide equal access to health care,” Scardaci said.

The program is expected to cost $6 million to $9 million across the 35-county consortium over the two-year period, though more money could be allocated depending on the need. The consortium currently receives $30 million a year in what are termed realignment funds to cover counties’ health coverage needs for the poor.

The coverage for undocumented adult immigrants would extend benefits to a segment of the population largely left out under Obamacare.

County officials estimated that two aspects of the federal health care overall - the federal expansion of Medicaid, known as Medi-Cal in California, and the creation of subsidized health care exchanges - would benefit 50,000 of the estimated 70,000 uninsured county residents.

But many undocumented immigrants were left behind, said Pedro Toledo, chief administrative officer for the Petaluma Health Center.

Toledo, who is knowledgeable of government-subsidized health insurance enrollment issues, said that undocumented immigrants traditionally access health care in the emergency room, which is often expensive. Giving immigrants access to CMSP preventative care could result in lower health care costs for this population, he said.

“The opportunity is really to provide them with prevention-?focused care so they don’t end up in the emergency room,” he said. “It should result in lower health care costs overall.”

Another related shift in health care came last month, when Gov. Jerry Brown struck a budget deal that would offer health coverage to undocumented children.

Sen. Ricardo Lara, D-Bell Gardens, also is pushing a bill that would allow undocumented immigrants to buy medical insurance through Covered California, the state’s health exchange. SB 4 would make undocumented adults eligible for Medi-Cal.

CMSP was started in 1983, when the state transferred to the counties the responsibility of providing health care services to uninsured poor adults. After 1991, the program became financed by realignment dollars - money shifted to local governments to cover justice, health care and other programs - as well as vehicle license fees, sales tax and county contributions.

The county program was meant to cover those who were not eligible for Medi-Cal, including those who either made too much money to qualify or not enough.

In the aftermath of Obamacare, and changes it caused in CMSP enrollment, the consortium’s governing board began a strategic planning process eight months ago to figure out how it would expand coverage to those left uninsured after the implementation of the Affordable Care Act. The consortium is made up mostly of small rural Northern California counties, including most of the Sierra Nevada foothills and the North Bay.

Toledo said the CMSP, through a third-party administrator, contracts with a number of local health care providers, including local hospitals, community clinics and private physicians.

But most of the newly enrolled members likely will be treated at one of the county’s nonprofit clinics.

“The vast majority will get their care at one of the health centers or one of the hospitals,” he said. “But that doesn’t preclude them from getting care at one of the other privately contracted providers.”

You can reach Staff Writer Martin Espinoza at 521-5213 or martin.espinoza@pressdemocrat.com. On Twitter @renofish.