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By Tim Moran
Native American tribes unite to form a county-like group that will administer healthcare reform on reservations – and be responsive to the health needs of American Indians and Native Alaskans.
As California begins to build a new health benefits marketplace that will be part of federal health reform, counties are debating whether to allow their public health insurance programs to be among the plans offered to consumers. Orange County has quickly decided to keep its public program out of the marketplace, but other counties, including Santa Barbara and San Francisco, may go the other way.
The Bridge to Reform is a $10 billion program that will transition low-income residents in California to a Medicare-like health coverage before the 2014 federal health care coverage mandate kicks in. That funding could bring much-needed changes, like providing patients with a medical home where they can get preventative care and where their medical histories are kept on file. But cash-strapped counties are worried – will the costs of extending coverage overrun their available funds, even with help from federal dollars?
As President Barack Obama struggles to implement — and defend — the health care reform he signed last year, he is finding that the public does not understand how the program is supposed to work, and based on what they do know, many voters doubt the overhaul will help them in the end.
It turns out this is true not only for middle class voters who already have insurance but, at least in California, also for low-income, uninsured people for whom the new law holds the most promise. Many of them are confused about the law’s details and fear it could make their ability to access care, often portrayed as desperate, even worse.
And the centerpiece of the law — the so-called “individual mandate” requiring everyone to obtain insurance coverage, seems to be no less controversial among the poor than it is among middle-income and affluent people.
Eleven thousand Monterey County residents are expected to be eligible for healthcare benefits under the Bridge to Reform program, according to an estimate by the UCLA Center for Public Health Research.
But the county can only afford to insure 1,000 to 1,500 of them this year, even though the federal government will match its spending dollar for dollar.