Manatee indigent care qualifier may require lower income

After 90 minutes of passionate and productive debate Wednesday night, the Manatee County Healthcare Advisory Board proposed a new model for health care for the indigent population.

Although preliminary and not yet ready to send to the Manatee County Commission for approval, the board proposed changing indigent care eligibility from those whose income is 200 percent or below the federal poverty level to 100 percent below the federal poverty level. The move would make it more difficult to obtain indigent care eligibility.

For a family of four, 100 percent or below the poverty level is between $25,000 and $28,000 annually, Windon said.

“It is a very low income level,” Windon said.

The 200 percent now honored by the county for health care is around $45,000 for a family of four, Windon said.

Meeting on the ninth floor of the County Administration building, the board did not propose changing other eligibility factors, which now require people to be between the ages of 18 and 64, unable to get insurance and Manatee County residents.

Those younger than 18 and older than 64 can be covered by government insurance programs, board members said.

“It’s a starting point,” said board member Philip Brown.

During the board’s next meeting Aug. 24, it will study the “ripple effect,”of changing the criteria from 200 to 100 percent, said Deputy County Administrator Karen Windon, who helped monitor the meeting along with Cheri Coryea and Andy Guyre.

Board members made the decision to go to 100 percent after learning changes to the Affordable Care Act now make it possible for more people in the population to qualify for the health insurance exchange, Windon said.

“Now our work is to look at data and look at impacts and look what that means to our community,” Windon added.

Windon was not sure how many people would become nonqualifiers if the plan goes through.

“We have used that 200 percent for quite some time,” Windon said. “We have to look at the data.”

For the 200 percenters, the county now provides a Medicare-rate reimbursement for physicians who provide a spectrum of services from primary to specialty care, Windon said.

This year, the county budgeted $6.9 million for the 200 percenters. That money went to a mixture of local hospitals, physicians, nonprofits such as Turning Points, mental health and substance abuse agencies and others, Windon said.

Windon said she was not sure if county would save money by going to 100 percent because board members are also talking about “targeted outreach” to high-intensity users of the local hospital emergency rooms to make sure they are part of a new county system of care.

“There might be people out there who currently have not been seeking services that can have a higher quality of life because they can have their illnesses managed better,” Windon said.

This story was originally published July 27, 2016 at 8:52 PM with the headline "Manatee indigent care qualifier may require lower income."