April 23, 2010
  • 4/23/2010 - Local plan for health care expansion set aside 

    By Shaun Bishop 

    The Daily News 


    Following the passage of federal health care reform, a coalition of San Mateo County 

    leaders shelved an ambitious plan to expand health care coverage to thousands of 

    uninsured Peninsula residents. 


    The members of the Blue Ribbon Task Force on Adult Healthcare Coverage Expansion 

    had aimed to offer coverage to up to 44,000 low-income adults, but the group never 

    resolved the crucial question of how to pay for the effort. 


    After meeting Monday for the first time in over a year, task force members decided to 

    halt work on a local plan and focus on helping county health officials implement the 

    2,700-page health care legislation signed by President Barack Obama last month. 


    Supervisor Adrienne Tissier said the federal reform will make affordable coverage 

    available to uninsured residents, essentially accomplishing the same mission the task 

    force set out to tackle when it formed in September 2006. 


    "Truthfully, there were definitely some times where we really didn't think health care 

    reform was going to happen, so we never stopped," said Tissier, who co-chairs the task 

    force with Supervisor Carole Groom. "We never lost sight of the goal and fortunately 

    health care reform came, and that really was our goal." 


    Made up of representatives from labor, hospitals, nonprofits, business and government, 

    the 36-member task force originally aimed to expand coverage to low-income adults ages 

    19 to 64 who aren't covered by other government programs but can't afford private 



    Officials believed between 36,000 and 44,000 uninsured people would qualify, allowing 

    them to get care at clinics and hospitals in the county by paying a premium of up to $100 

    per month. County officials said the program would reduce costs by having fewer 

    uninsured people visit the emergency room for primary care. 


    But the group never devised a way to fund the expanded coverage, which a consultant 

    estimated in 2007 would cost about $300 monthly per person or up to $150 million in 



    "There was no dedicated funding source, and the challenge is always to try to get those 

    who are not paying today to be willing to pay," said Assemblyman Jerry Hill, D-San 

    Mateo, who launched the task force with Tissier when he was a county supervisor. 


    After ruling out a potential countywide tax, a 20-member subcommittee decided in 

    January to pursue a minimum spending requirement for employers, similar to the 

    employer mandate in San Francisco's health system. But the funding plan didn't make it 

    to the full task force before the passage of health care reform in March. 


    Furthermore, the county would have had to convince each of the 20 cities in the county to 

    sign on to the employer mandate idea, no small challenge even in good times. 


    In the current economy, "I don't think (cities) could say to their businesses, 'Please assess 

    a tax,'" Groom said. 


    Task force members said the research collected in the past few years should be used to 

    help county health officials prepare for the rollout of federal reforms in 2014. 


    "We're already prepared in a lot of ways to think about how we execute the 2014 

    obligations to the county," said task force member Luisa Buada, CEO of the Ravenswood 

    Family Health Center. 


    Tissier said she believes local health reform efforts like the task force's and others in Bay 

    Area counties helped convince local members of Congress that "they had our full support 

    to be engaged in health reform, and they helped fight that battle." 


    Groom said the group had some important accomplishments since it was formed, 

    including helping start a pilot health coverage expansion called Access and Care for 

    Everyone, which was funded by a three-year $21 million federal grant. The program has 

    about 6,700 people enrolled. 


    In another example of local health reform, Santa Clara County rolled out last month a 

    voluntary, inexpensive insurance program for businesses with less than 50 employees. 


    Hill said San Mateo County's effort was different because it pursued a broader 

    commitment from employers. He said he isn't disappointed that the county's effort didn't 

    come to fruition. 


    "I think it served a great purpose in identifying and focusing on the problem and potential 

    solutions," Hill said. "Now we've got one in hand."