The Galveston County Daily News

County commissioners today will consider a plan to spend more money on indigent health care as part of a pilot project leading up to an election to create a hospital district. Commissioners are scheduled to vote to increase the eligibility level for the county’s poorest residents to receive hospital services paid for with county tax dollars.

By state law, the county must pick up the tab for indigent health care. The minimum standard is to pay for the hospital health care needs of someone who meets 21 percent of the federal poverty level standard.

For about 10 years, the county has paid for the hospital and specialty care for residents who meet that minimum standard. A total income for a family of four can be no more than $4,600 to be eligible for county-subsidized health care.

If commissioners approve the plan, the eligibility level would increase to 50 percent of the federal poverty level, about $11,025 in income for a family of four. County Judge Jim Yarbrough estimated that by making more people eligible for hospital and specialty treatment, the county would pay about $1.5 million more a year.

The county already budgets about $2.5 million annually for indigent hospitalization care.

The plan is separate from general health care coverage, such as doctor’s visits and basic medical treatment.

The county 4C’s clinics provide health care for residents up to 200 percent of the poverty level.

Good Faith Gesture To Austin

The proposed increase is supposed to be a good faith move by the county as the state legislature considers continued funding of the University of Texas Medical Branch. While the legislature is on track to approve funding Hurricane Ike repairs and rebuilding, long-term funding for operations still is uncertain.

Many in Austin complained the county has not done enough to pay its part of the tab for health care, including creating a hospital district that levies taxes. Since the indigent hospitalization and specialty care plan acts much like a private insurance plan, Yarbrough hopes upping the eligibility requirement would be a sign of the county’s willingness to contribute more to indigent care costs.

More Residents Eligible

Yarbrough estimates that, under the new plan, as many as 10,000 county residents would be eligible for subsidized hospital and specialty care.

“We are talking about the poorest of the poor here,” he said.

Before lowering the threshold in 1998 to 21 percent, the county paid the hospital tab for residents at 100 percent of the poverty level, Yarbrough said. Going back to that level would require either a tax increase or creating a taxing entity such as a hospital district.

Tax Hike vs. Taxing District

Because a tax increase would push the county’s tax rate to a level subject to a rollback vote, Yarbrough said the better option is to see what effect the 50 percent threshold would have on the county budget and then let voters decide in November if they want to create a hospital district.

Unlike hospital districts in Harris and Montgomery counties, any district in Galveston County would not build or operate hospitals but rather would work as an insurance system for the poor and would pay for hospitalization and specialty care at the medical branch’s John Sealy Hospital, Mainland Medical Center in Texas City or any hospital with which the county contracts.

Yarbrough said the county’s current screening process can easily adjust to the new percentage and would limit fraud.

“There are those who complain that ... we are serving illegal (immigrants), and that is not the case in general,” he said.

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At A Glance

WHAT: County Commissioners meeting

WHEN: 8:15 a.m. today

WHERE: County Courthouse, 722 Moody Ave., in Galveston