County Health Plan Enrollment Numbers Just Short of Projections

Valley Health Plan has managed to capture about 3 percent of the Santa Clara County market under Covered California, which is slightly below state levels. Though this figure pales in comparison to enrollment figures reported by the top four major healthcare providers, and it’s not as strong a figure as county officials expected two months away from the end-of-March enrollment deadline, it does represent a comparable market share to other small, local health plans, according to county officials.

Ninety-six percent of Californians signing up under the Affordable Care Act (ACA) picked one of the big four insurance providers: Kaiser, Blue Cross, Blue Shield and Health Net. The remaining 4 percent picked one of the other seven plans offered in the healthcare exchange. Locally, that contrast was 97 percent to 3 percent, respectively. Part of the reason most people favor bigger providers may stem from name recognition and familiarity with plans, or partly because the bigger health plans offer statewide coverage, whereas a county’s only offers coverage in a given region.

René Santiago, deputy county executive and director of the Santa Clara Valley Health and Hospital System, will discuss enrollment figures during a monthly update Wednesday before the Health and Hospital Committee.

A top priority for the year ahead is rolling out federal healthcare reforms under the Affordable Care Act, Santiago told San Jose Inside. In the coming months, the county will look at how well it’s retaining patients, how much it’s reducing the number of uninsured residents, whether they’re getting quality care in a timely manner and whether the viability of public healthcare is improving. Santiago said he expects the county health system to see an increase of 10,000 patients in the year ahead, mostly because of federal health reforms.

“Our work is no longer preparing for reform,” he said. “Now we must focus on making reform successful.”

California leads the nation in enrollment under both Medi-Cal expansion and the state-run health exchange known as Covered California. Less than two months from the enrollment deadline, March 31, a million Californians have signed up for both programs under the ACA expansion.

Countywide—and in the greater Bay Area—the numbers have exceeded baseline scenarios, Santiago said. More than 20,000 people under the Valley Care program signed up for Medi-Cal and the bulk of them opted to continue their pre-existing provider coverage with the county health safety net.

“It’s still early since the deadline doesn’t come for another two months, but early reports show that Santa Clara Valley Medical Center and our community-based provider network has successfully retained this target population,” Santiago said.

Under the ACA, all legal residents and U.S. citizens must have health insurance. The county’s Social Services Agency runs a call center from 8am-8pm, Monday through Saturday, to field questions about the new law and help people apply for coverage. That phone number is 800.300.1506.

Email tips to [email protected]. Follow her on Twitter at @jennwadsworth.

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

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