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Obamacare could rival county service

Posted: December 5, 2012 2:00 a.m.
Updated: December 5, 2012 2:00 a.m.

 “Obamacare,” the Patient Protection and Affordable Care Act, could seriously cut into funding for the Los Angeles County Department of Health Services and the people it serves, supervisors heard in a report Tuesday.

“History is not in our favor,” said health services Director Mitchell Katz. “Our county has not proven in the past that it can attract people when there is a choice (in coverage).”

The problem, Katz said, is that federally funded Obamacare will offer services that may compete with county systems.

Under the new health care law, access to Medicaid will expand in January 2014 to include those with incomes within 138 percent of the national poverty line.

This means as much as 50 percent of the currently uninsured patients the department serves could gain access to Medicaid, Katz said. This could lead some to abandon county health services for federal ones.

Any kind of exodus from county-provided services could present a “dire scenario” for the county, Katz said. The loss in revenue could cut funding to some of the system’s fixed costs, such as hospital operations.

“We have made huge amounts of progress in the past two years” in streamlining services, Katz said. “And (the Department of Health Services) is taking steps to remain a provider of choice in 2014.”

Katz also said it is necessary to accelerate changes in department services between now and January 2014.

Quick action becomes even more important with California Gov. Jerry Brown expected to call a special session of the state Legislature next month specifically to address the national health care law.

Katz said the challenge now is finding ways to provide better, more efficient services while spending less money.

Supervisors discussed several ways to help the Department of Health Services meet its goals. Supervisor Zev Yaroslavsky proposed convening a task force to help bring the different stakeholders to the same table.

“The stakes here are very, very high,” Yaroslavsky said.

Supervisor Mark Ridley-Thomas suggested having at least monthly updates on the department’s progress. These updates would also allow department representatives to let the supervisors know if there is anything they can or need to help with, Ridley-Thomas said.



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