Panel Favors County Health Plan for Welfare Reform Participants

Ventura County should proceed with a plan to offer low-cost health insurance to people enrolled in its welfare-to-work program--and anyone else working for the employer that hires them, according to a new grand jury report.

A proposal developed by county officials to offer the insurance to participants in the CalWORKS state welfare reform program is “a long overdue need,” and any profits the program collects could be used to improve the aging county hospital, the report states.

The insurance would cost $150 to $175 per month for a family, with no deductibles and low co-pays. Premiums would be shared among the recipient, the employer and, when necessary, the county.

And as an incentive for employers to participate, all of their employees, not just the ones coming off of welfare, would have access to the low-cost county health plan.

The program was developed under the premise that many small business owners cannot afford insurance for their workers, and the 8,800 or so welfare families in the county should be within reach of some form of health insurance, according to the grand jury report.

But representatives of Community Memorial, the nonprofit hospital across the street from the Ventura County Medical Center in Ventura, contend that the county plan was drafted with something else in mind: making money. They say there are plenty of private firms providing low-cost insurance, so there is no need for the county to provide the service.

“Here they go again, trying to compete with the private sector,” said Michael Lurie, director of managed care at Community Memorial, which was involved in a successful $1.6-million campaign to stop construction of a new $56-million outpatient center at the county hospital in 1995.

“I think they’re doing it to further their goal, which is to run more patients through the county and the county hospital and away from private providers,” Lurie said.

Supervisor Frank Schillo said Friday he is still debating the pros and cons of the insurance proposal.

On the one hand, he believes there is a need to provide low-cost insurance to welfare recipients, many of whom show up at the county hospital with serious needs and no coverage.

“Right now, we are in a position where we have to pay for their medical services--which is fine, that’s what we’re supposed to be doing as a county--but it’s also very expensive,” Schillo said. “Those people who do not have insurance are not contributing anything.”

On the other hand, he said he does not want to compete with insurance companies.

“My concern is that we not do anything to compete with the private sector,” Schillo said. “I don’t want to compete with health insurance companies.”

Because the county already has a special state license to run its own HMO--which Community Memorial lobbied hard to block--it could legally provide the low-cost health insurance to welfare recipients who reenter the job market. It already provides a form of inexpensive insurance to county employees.

The grand jury report recommends that a county agency such as Ventura County Medical Center underwrite the health insurance, which it estimates could result in an annual income of $7 million to $9.6 million.

The annual amount that would be collected from all welfare families is estimated between $15.8 million and $18.5 million, according to the report. Assuming that the yearly medical bill for each family averaged $1,000, the annual cost for benefits would be about $8.8 million.