A report released yesterday by Health Access, a not-for-profit consumer advocacy group, shows a wide variation in indigent care from county to county in California.
That variation is particularly important now, said Anthony Wright, executive director of Health Access, because counties will decide in the next two weeks how their indigent care will be designed.
"In some counties, there's exciting progress," in terms of the scope of indigent care being planned, Wright said. "At the same time, we also see California will have a patchwork of indigent care and services."
In last year's budget, county funding was reallocated, putting counties in the position now of deciding what funding formula they will use, Wright said.
"Those decisions will be made in the next few weeks, and this report puts a spotlight on those decisions," Wright said. "California is at a pivotal moment in the next month."
The county-by-county breakdown of existing services and expected plans for services is the first study of its kind since 2009, Wright said.
The Affordable Care Act and the expansion of Medi-Cal starting in 2014 will help approximately half of the uninsured and underinsured in the state, Wright said. But that still leaves up to three million or more Californians without adequate coverage, Wright said.
"This [segment of the population] will largely be left to the counties," Wright said, "and they have considerable discretion about the kind of care they will provide."
Even after millions of Californians get coverage through Covered California or through expanded Medi-Cal, there will be millions more without coverage, and overtaxing the emergency departments across the state, said Sen. Ed Hernandez (D-West Covina), chair of the Senate Committee on Health.
"We still have a lot of work to do," Hernandez said. "We still have a large population that is uninsured and underinsured. … I really believe if we're going to be successful, we have to look at the safety net."