County launches temporary bridge to Obamacare, but covers fewer than hoped.

When Vivienne Moore was passing painful gallstones, doctors at Community Hospital of the Monterey Peninsula advised her to spend the night for observation. But Moore declined because she couldn’t afford an overnight hospital stay.


“I said, ‘I’ll take my chances,’” Moore recalls. That was in 2001; she still has no health insurance. 


The 64-year-old was fourth in line at Natividad Medical Center in Salinas on March 4, where she arrived at 6:45am to enroll in ViaCare, the county’s new low-income health plan. 


It’s a temporary insurance plan for uninsured people who earn less than the federal poverty level (for couples, $1,261 a month). ViaCare is designed as a bridge to 2014, when the federal Affordable Care Act, known as Obamacare, takes effect. 


ViaCare was years in the making, held up by concerns that Natividad couldn’t afford as expansive a program as was originally proposed. 


The feds will add $2.5 million to the county’s $5.5 million contribution to the plan, which could cover about 500 people. It’s about a third the size of the program under discussion six months ago, because county officials determined a larger pool would be too risky a financial burden for Natividad to take on. 


Activists with SEIU United Long Term Care Workers and Communities Organized for Relational Power in Action, a coalition of 25 community and faith-based organizations, pressed for a program that would include the working poor, rather than just the most impoverished uninsured. 


Of an estimated 90,000 uninsured Monterey County residents, about 15,000 qualify for ViaCare. Enrollment is on a first-come first-serve basis; on the launch date, 37 people submitted completed applications. 


The county Health Department will deliver outpatient care for ViaCare enrollees, meaning an estimated 2,000 new appointments a year. The Health Department already handles about 160,000 visits annually. But ViaCare also sets the stage for more robust well-care, providing more comprehensive coverage than Medi-Cal.


Even if ViaCare maxes out at 500 people, the program is expected to last only until Jan. 1, when Obamacare kicks in. Monterey County is the state’s second-to-last county to launch its bridge plan. 


“In an ideal world, this would’ve been operating a long time ago,” County Health Director Ray Bullick says. “It has diminished value, but I would never say it has no value. For 500 people, they’re going to be moved from a life of anxiety into a covered insurance environment.”


For Moore, ViaCare will mean a routine blood pressure check, something she’s been worried about for years. “I was afraid I was going to stroke out,” she says. 


Moore recently moved into her friend’s garage after being laid off. As she fills out the ViaCare application, she says, “I’m glad they take a P.O. box.”