SAN DIEGO, CA — County supervisors Monday unveiled a reform plan intended to keep more than 120,000 San Diegans from losing Medi-Cal coverage when program requirements change.
Board Chair Terra Lawson-Remer and Vice Chair Monica Montgomery Steppe will present the reforms during Tuesday's Board of Supervisors meeting. The proposals follow recommendations from county staff after a March vote and are intended to modernize County Medical Services by removing barriers to health care, including property liens, credit checks, reimbursement agreements, some in-person appointments and red tape.
"County Medical Services is supposed to help people who have nowhere else to turn, but some of its requirements have made getting care unnecessarily difficult," Montgomery Steppe said. "These reforms are an important step toward making health care more accessible, and we know there is more work ahead as federal changes threaten coverage for thousands of San Diegans."
Changes under the Trump administration are projected to cause 68,761 San Diegans to lose Medi-Cal coverage because of new federal work requirements. Another 67,630 people currently receiving full-scope Medi-Cal are projected to lose that coverage because of immigration eligibility changes, according to a statement from the supervisors.
"San Diego County must be prepared now to protect our health care system from the severe federal funding cuts and rising costs coming at us. People don't stop getting sick when they lose their health coverage," Lawson- Remer said. "When Washington creates holes in the health care safety net, the consequences eventually show up in our clinics, in our hospitals and in our emergency rooms."
Medi-Cal is California's Medicaid program, providing free or low-cost health coverage to people who qualify.
The board voted 4-1 in March to study reforms, forming an ad hoc subcommittee composed of Lawson-Remer and Montgomery Steppe. Supervisor Jim Desmond, the lone "no" vote, said he was concerned about the lack of transparency in the subcommittee's work.
One of the major changes Lawson-Remer and Montgomery Steppe hope to make involves property liens that applicants may be required to sign, allowing the county to secure repayment of county-paid medical expenses against real property.
"For a program intended to serve people with nowhere else to turn, that creates a basic contradiction: accessing last-resort health care can also mean accepting a long-term financial claim against one of the most important assets a family can build," a statement from the supervisors' offices said.
Tuesday's proposal would eliminate the lien requirement, release existing liens and end lien-based repayment for services.
— City News Service
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