Logo courtesy of County Medical Services Program (CMSP)

AUBURN, CA (MPG) - With around 7,000 Placer residents expected to lose Medi-Cal (California’s Medicaid program) in the coming year, Placer County is searching for solutions to help meet its legal requirement to provide indigent health care even as costs soar.

On June 30, the county’s Board of Supervisors approved an agreement to join the County Medical Services Program, a move aimed at preserving access to basic health care for eligible residents who lose coverage. However, officials stress the need for more state support to help counties meet state requirements.

“Counties are being asked to shoulder growing responsibilities as the number of residents needing these services will rise,” said Board Chair Shanti Landon, who represents the county’s District 2. “If the state expects counties to deliver on this mandate, it must provide the funding necessary to do so. Without meaningful additional support, local governments will likely be forced to divert resources from other critical services to cover these costs.”

Indigent care refers to basic medical services provided to low-income adults who cannot afford health coverage that counties are legally required to provide under California Welfare and Institutions Code 17000.

Without state-level action, counties will see indigent care costs grow substantially, even though dedicated funding for these programs has largely disappeared. The state Legislature had approved allocating $125 million to help establish Protect Access to Healthcare, a “fail-safe” emergency services only Medi-Cal benefit for residents who lose Medi-Cal eligibility due to federal work requirements.

That benefit would have redirected many of those residents away from county medical indigent care programs, which had largely fallen by the wayside under the Affordable Care Act and recent expansions to Medi-Cal that mainly covered more low-income adults. However, the final agreement between the Legislature and the governor excluded this benefit, placing greater pressure on local budgets.

Placer’s 30-month agreement with CMSP, valued at up to $23.7 million – a figure that could decrease if the state eventually takes action – will primarily provide eligible low-income adults with basic coverage for primary care from April 1, 2027 through Sept. 30, 2029. The program already serves 35 counties statewide, including Placer and other CMSP counties where Partnership HealthPlan separately serves as the Medi-Cal managed care plan.

Placer County Health and Human Services estimates that nearly 7,000 residents could lose adult expansion Medicaid coverage primarily due to new federal work requirements. CMSP estimates that just over 2,000 Placer residents might enroll in indigent care.

“Joining CMSP gives residents a reliable way to receive basic medical care, but it doesn’t change the bigger picture,” said HHS Director Dr. Rob Oldham. “Counties across California are being asked to do more with less. We’re trying to meet our obligations while working with partners to help as many folks as possible keep their Medi-Cal so that we can mitigate indigent care costs. At the end of the day, though, long-term sustainability requires partnership from the state.”

Placer County expects to cover first-year CMSP costs of about $2.6 million using its annual 1991 Health Realignment allocation and fund balance. While these resources shield the County General Fund in the short term, officials warn that rising indigent care costs would create long-term fiscal pressure if the state does not restore or replace funding that previously supported these services.