Health System: Health Coverage Unit (5510B)

Program Outcome Statement

Maximize health insurance coverage among low-income residents.

Program Services

  • Health Outreach and Enrollment Assistance
  • Eligibility Administration

Overview

The Health Coverage Unit (HCU) engages in outreach and assistance to connect low-income residents to health coverage, with a focus on clients who seek services at the Health System’s medical and behavioral health locations.
HCU aims to offer “one stop” assistance to help residents enroll in the health coverage programs for which they are eligible. HCU administers eligibility for the County’s local programs (ACE and Healthy Kids) for those who do not qualify for other federal and state health insurance programs. HCU also assists clients in navigating the local healthcare safety net to assure that coverage can promote access to needed healthcare services. HCU also advocates on the state and local levels for systems and policies that make the process easier for consumers and more efficient for government.
The Health Coverage Unit reached approximately 39,000 residents during FY 2016-17 and assisted them in successfully enrolling in health insurance coverage programs.

Percent of Children Insured in San Mateo County Exceeding Target

Number of San Mateo County Residents in Covered California Below Target


Number of San Mateo County Residents Enrolled in Medi-Cal through ACA Meeting Target

FY 2017-18 Mid-Year Story Behind Performance    

Percent of Children Insured in San Mateo County

HCU continues to prioritize outreach and retention approaches that make it easy for children to be or remain insured. This is achieved by partnering with the County of San Mateo's Human Services Agency as well as targeted schools and community-based organizations that families trust.

Number of San Mateo County Residents in Covered California

The sustanined strong economy has resulted in robust employer-based coverage and less reliance on the individual marketplace.  Additionally, the tax law enacted by Congress removes the requirement that individuals purchase health insurance, which will likely mean some decreased take-up, especially among healthy inidividuals.  We therefore expect a 10% decrease in Covered CA enrollment.

Number of San Mateo County Residents Enrolled in Medi-Cal through ACA Expansion

HCU continues to prioritize outreach and retention approaches that make it easy for eligible clients to get or remain insured. This is achieved by partnering with the County of San Mateo's Human Services Agency, as well as the targeted community-based organizations that clients trust.

Future Priorities

  • Adapt our enrollment assistance strategy to maintain the trust of our clients while responding to any federal changes to the Affordable Care Act.
  • Implement a successor local eligibility software system.
  • Implement an improved approach to collect client feedback to support continued excellence in customer service.
Author: Gina Wilson, Chief Financial Officer, Health System     Contact Email: gwilson@smcgov.org     Last Updated: 01-24-2018