FARMINGTON — San Juan County commissioners Tuesday could approve proposed deep cuts to a fund that partially pays health care providers' uninsured medical claims.
These revisions to the indigent health care fund, according to county documents, would cut in half the reimbursements many of the health care providers receive for uncompensated care claims. If the cuts are approved, those providers say the consequences will be grim.
"The fact that we're having to reduce the reimbursement rate to 33 percent is not good," Commission Chairman Jack Fortner said. But "it's better than paying zero."
The current rate is 70 percent.
The revisions to the indigent fund — which soon will be known as the "health care assistance program" — are numerous and severe. They are an attempt to avoid bankrupting the fund as the county tries to comply with Senate Bill 268.
That bill, passed in the recent legislative session, created the Safety Net Care Pool, which requires counties to contribute one-twelfth of 1 percent of their gross receipts taxes to a fund that helps finance hospitals' uncompensated health care claims. It requires San Juan County pull $3 million from its projected $4.2 million indigent fund.
"That's most of it," said Liza Gomez, the fund's director. "That's three-quarters of (the fund), really."
The indigent fund also helps county residents pay health care bills, but the revisions will reduce the number of people who are eligible. According to county projections, 329 households would lose eligibility if the commission raises the indigent fund's income guidelines to 200 percent of the federal poverty level. Gomez said this will mostly impact single-person households, which are 90 percent of the households that benefit.
The change would save $840,251, according to county documents.
The indigent fund pays claims up to $45,000 but the revisions would limit these reimbursements to a $10,000 per-claim maximum. Gomez said the reduction will most impact hospitals, which have the most high-dollar claims.
This change would eliminate a projected 267 claims and save the county about $3.3 million, according to the documents.
Many county residents eligible for the indigent fund's services apply several times, and 19 have exceeded $100,000 in claims, according to county documents. The revisions would reduce the fund's lifetime limit from $250,000 to $100,000.
This change would have denied 268 claims in fiscal year 2013 and saved the county $1.4 million, according to the documents.
To be eligible for the indigent fund's services, households need to document money in stocks, bonds or checking or savings accounts. These are known as liquid assets.
Currently, one-person households can have no more than $10,000 in liquid assets, two-person households no more than $20,000 and three-or-more-person households no more than $30,000, according to county documents. But the revisions would reduce one-person households to no more than $5,000 and two-or-more-person households to no more than $10,000, according to county documents.
This change would have omitted 36 households, saving the county $198,427, according to the documents.
Fortner said the revisions — especially the one that more than halves the health care providers' reimbursement rate — are hard decisions. But, he said, they could be worse.
"It's like the best of the worst alternatives," he said.