STANISLAUS COUNTY -- Stanislaus County could provide health care for fewer younger adults and raise the eligibility ceiling for a larger number of older adults to enter the indigent health program.
County supervisors will consider the new age-based eligibility guidelines at a public hearing today. The indigent health program serves about 9,000 of the county's poorest residents, including adults who don't have children at home and don't qualify for other government programs.
The state requires the county to provide health care for poor adults ages 21 to 64. Low-income single moms and children often are covered by Medi-Cal, and seniors 65 and older are eligible for the federal Medicare program.
The county program fully covers the cost of health care for poor adults with incomes of less than $1,110 a month. The changes proposed today would apply to residents with incomes exceeding $1,110 a month; those adults are expected to pay for a share of their health care costs.
Legal precedents require counties to use a cost-of-living analysis to determine who's eligible for indigent health care, but the new guidelines also would factor in the cost of buying health insurance in California, said Mary Ann Lee, managing director of the Stanislaus County Health Services Agency.
Because health insurers charge different rates to people in different age groups, the agency is proposing age-based income guidelines, Lee said.
County residents in their 20s with incomes of $1,110 to $1,637 a month would be eligible. Officials reason that people in their 20s who earn more than $1,637 a month should be able to buy insurance for about $433 a month, while paying for rent, food and other expenses.
Younger adults usually are charged lower premiums for insurance because they are considered healthier and don't require as much medical treatment.
Health insurance may cost triple that amount for adults ages 60 to 64, so the county's eligibility limit would be higher for that group. Older adults earning less than $2,671 a month would qualify.
The proposed income limits for other groups are: up to $1,965 a month for people in their 30s; up to $1,949 a month for people in their 40s; and up to $2,347 a month for people in their 50s.
According to legal notices, about 82 people currently enrolled no longer would be eligible for the program.
Under current guidelines, adult county residents earning from $1,111 to $2,135 a month are eligible for the program's hardship status.
Lee said that including the cost of insurance in the analysis is a fair way to set the income limits. Officials may need to adjust the guidelines when more affordable insurance is offered to uninsured adults through Obamacare next year.
Lee said she doesn't believe that changing the guidelines will increase or reduce the overall cost of the indigent health program. The county budgeted $12.7 million for indigent health this year.
The Board of Supervisors will hold a public hearing on the eligibility rules at 9 a.m. today in the basement chamber of Tenth Street Place, at 1010 10th St., Modesto.
Bee staff writer Ken Carlson can be reached at kcarlson@modbee.com or (209) 578-2321.
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