2/21/2009 - Recession affects health care effort
By Shaun Bishop
Redwood City Daily News
 
Even before the national economy took a nosedive, San Mateo County leaders faced a daunting task in convincing local businesses to help fund a plan to extend health care coverage for up to 44,000 uninsured adults.
 
With businesses now facing a deepening recession, there is still no clear answer on how the coverage plan would be paid for, more than two and a half years after the Blue Ribbon Task Force on Adult Health Care Coverage Expansion began working on the issue.
 
But despite the challenge of raising between $100 million and $150 million to fund the plan, proponents say the effort is not dead yet.
 
A 20-member subgroup of the original 36-member task force continues to meet every month behind the scenes, hoping to come to a consensus on the best way to fund the project.
 
Suggestions include a countywide sales tax, a mandate that businesses provide employee health care or a voluntary program where businesses contribute to a health care fund. All may provoke dissent in the business community.
 
"We know that every one of these roads is going to be difficult — not just because of the economy, but because of all the other tax and financial burdens that are placed on businesses and individuals," said Supervisor Carole Groom, who chairs the 20-member subgroup.
 
The ultimate goal of the task force — composed of representatives from government, labor, business and nonprofits — is to provide health coverage for uninsured residents ages 19 to 64 with incomes of up to 400 percent of the federal poverty level, or about $88,000 a year for a family of four.
 
Officials believe there are between 36,000 and 44,000 uninsured people who would qualify and are not covered by other government programs like Medi-Cal.
 
The task force completed a set of broad recommendations last year, including that enrollees pay between $25 and $100 per month for their coverage, depending on income. But a consultant has said coverage will cost around $300 per person to provide, so other funding sources are needed.
 
Business leaders have said previously that they are worried the Blue Ribbon plan would place a disproportionate share of the cost on small businesses, saying some may not survive the recession if they are pegged with an additional cost.
 
Groom said there is no deadline for the 20-member committee to decide on a funding plan "because I'm opposed to forcing this. I think we have to do it right." She said the group is "very, very aware of what a tough business climate this is" but hopes to find a solution that businesses can get behind.
 
"The goal is not to provide hardship, the goal is really to provide health care," Groom said. "Let's face it, there are sadly more and more people losing their jobs and (they) are going to be relying on the public health system."
Even though the cost question hasn't been settled, the county has been preparing to accept tens of thousands of new patients in to the public health system, said health system spokeswoman Beverly Thames.
 
The county is also trying to recruit new hospitals and physicians to take on patients covered by the Health Plan of San Mateo, which runs the county's Medi-Cal and children's health programs and would also administer the Blue Ribbon program.
 
"You can say, 'I'm covering all these people,' but if there's no health care providers to provide them service, then it's really not a working system," Thames said.