County estimates $155M tab for uninsured 

Health officials Monday got their first look at what caring for the county’s 44,000 uninsured adults could cost, and it wasn’t cheap.

Initial estimates by independent actuary firm Milliman put the cost at around $294 a month per person, or as much as $155 million a year, to cover the county’s entire uninsured population, Milliman’s representative Stan Roberts said.

Roberts presented the statistics to the county’s Blue Ribbon Task Force on Adult Health Care Coverage Expansion on Monday.

The task force is among the first in the nation to attempt to tackle skyrocketing health and indigent care costs at the county level in light of what is widely viewed as a failure to address the issue by the federal and state governments.

There are an estimated 36,000-44,000 uninsured adults in San Mateo County who earn less than 400 percent — about $68,600 a year for a family of three — of the federal poverty level and would likely qualify for coverage under a county-developed plan.

San Mateo County’s indigent care costs — at the publicly funded SanMateo Medical Center, which covers 90-95 percent of indigent care costs — rose from $28 million in 2000 to $54 million in 2005, said S.T. Mayer, a county health policy analyst.

"It was sort of daunting to look at the costs [Milliman] put forth," said task force chair and county Supervisor Adrienne Tissier.

In addition, the $155 million, still considered a preliminary figure, doesn’t take into account the more than $34 million the county already pays to insure low-income families and an additional $33 million a year that local hospitals provide in charity care.

These figures would be largely eliminated by covering the uninsured, officials said.

Making up the difference between the costs and what is already spent is part of ongoing task force discussions, Mayer said.

"It shows we’re obviously not going to be able to do this with existing revenue," said task force member and county Supervisor Jerry Hill.

Ideas that have been floated include a mandate requiring employers or employees be insured, but other options are being considered, officials said.

Tissier, who pays about $400 a month for her own private health insurance coverage, said it was very difficult to see how low-income families without insurance would be able to come up with almost $300 a month.

The $294 per month average estimate is the maximum it could cost to provide individual coverage and doesn’t include a subsidy from the county based on income and other programs that may help the uninsured reduce the costs, Mayer said.

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