Obamacare Enrollment Drives Up County Hospital Revenue

Santa Clara County more than doubled its enrollment targets for the Affordable Care Act, a.k.a. Obamacare, driving up revenue for the Valley Health and Hospital System.

County officials expected to enroll 21,500 people newly eligible for Medi-Cal under President Obama's healthcare reforms, and budgeted accordingly. But enrollment is now expected to hit 48,000 this year, driving up revenue $85.6 million more than projected.

The Board of Supervisors will vote Tuesday on a budget modification to account for the increase.

Fortunately, Obamacare reimburses the county 100 percent of the cost. The increased revenue will make up for the spike in payroll and other expenses from the influx of patients. Hospital officials want to use some of the money to update its electronic records system, buy new equipment for the oncology department and replace a fire alarm system, among other things.

Covered California, the health benefit exchange created to implement the Affordable Care Act, has enrolled 1.4 million people to date. Medi-Cal, which insures low-income residents, added 2.7 million more beneficiaries and provided coverage for more than 12 million Californians.

Before Obamacare, the county had to foot half the cost of treating uninsured patients, primarily through Medicaid waivers that picked up just 50 percent of the tab.

More from the Santa Clara County Board of Supervisors agenda for April 21, 2015:

  • To save water in the thick of a historic drought, Supervisor Ken Yeager suggests replacing lawns at county-owned properties with drought-tolerant landscaping. He also proposes a decade moratorium on putting any new lawns or decorative fountains at county facilities. Last month, Gov. Jerry Brown urged local governments to replace 50 million square feet of lawns with drought-tolerant landscaping. It's possible, too, that the county could get some grants for the effort. Yeager cited Gov. Jerry Brown's directive to slash water use by 25 percent this year. “People should realize we are in a new era,” Brown said at a news conference earlier this month. “The idea of your nice little green lawn getting watered every day, those days are past.”
  • A little more than 11 percent of the county's foster youth take psychotropic medications, according to a report supervisors ordered in response to a Mercury News report about the over-medication of foster kids. That evens out to about the state average, according to the county. "There has been public concern about the potential for bias towards prescribing medication," the Social Services Agency report states. "However, any bias is against prescribing medication for minors."
  • The Office of Women's Policy wants the county to create a certification program that rewards companies with family-friendly policies. Under the proposal, companies would earn bronze, silver or gold according to the quality of their work-life balance, parental leave and accommodations for nursing moms.

WHAT: Board of Supervisors meets
WHEN: 9am Tuesday
WHERE: County Government Center, 70 W. Hedding St., San Jose
INFO: Clerk of the Board, 408.299.5001

Jennifer Wadsworth is the former news editor for San Jose Inside and Metro Silicon Valley. Follow her on Twitter at @jennwadsworth.


  1. That’s nice. Celebrate while you can as once the “Senate Bill 4” aka. “Health For All Act” is passed, we’ll sing a Kumbaya together with est. 4 Million+ of new “members”: http://sacramento.cbslocal.com/2015/04/13/healthcare-for-undocumented-immigrants-up-for-debate-at-california-capitol-this-week/

    Apropos Yaeger’s “new-lawns moratorium” suggestion and our current per capita daily water usage of ~180 gallons per person, how about an equivalent moratorium on the “Sanctuary City” policy?
    Oh, nevermind, that’d be considered racist. Sorry! I better stick to just paying my taxes and shutting the f+ck up…

    • And Congressman Joe Wilson, who stood up and yelled “YOU LIE!!” at Obama as the Liar in Chief was “dispelling the myth” that illegal aliens would be given Obamacare, will be owed an apology by the liberal press.

    • Damn right you better pay your taxes–4 million+ illegals are depending on you for their health care. Instead, why don’t we just send the bill for all the health care for the illegals to El Presidente Pena en Ciudad Mexico, D.F.? It’s probably just a small part of the skim he and other Mexican officials get from PEMEX.

      • …but local, state and federal budget problems are the result of public employee’s pay and pensions?

        Sounds like public employees may be at the end of the line when it comes to the hallowed “public trough.”

  2. Long ago the taxpayers spent many thousands of dollars to create a beautiful, iconic fountain at the entrance to the water district’s offices. It’s now full of dirt. The Santa Clara Valley Water District was way ahead of it’s time when it quit maintaining that beautiful fountain at it’s lavish headquarters on Almaden Expressway. Of course, that it was due to sheer laziness and incompetence doesn’t matter. The important thing is that now there’s more money to spend on bigger pensions for water baron Beau Goldie and his public employee crew.

    • JG: Only if the rate increase that is proposed because we have all conserved water goes through. Beau Goldie–sounds like a name for a guy in a novel about corruption in Louisiana.

  3. > Santa Clara County more than doubled its enrollment targets for the Affordable Care Act, a.k.a. Obamacare, driving up revenue for the Valley Health and Hospital System.

    Yay! More revenue!

    Life if good! Spend! Spend! Spend!

    Ummmmm. Where is this revenue coming from?

    The taxpayers, you say?


    $200 million deficit?

    High risk of future enrollments?

    No long term sustainability?

    The federal subsidies have ended. California is not going to fund the Covered California deficits, Eighty percent of new enrollments end up on Medi-Cal (can you say “general fund”?)

    In spite of Jennifer’s sunny optimism, Covered California is a fiscal trainwreck.

    Just like the California High Speed Rail fiscal trainwreck.

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