Expanding Health Coverage to Uninsured Workers in Santa Clara County

March 30, 2010 -- Working Partnerships USA

While the national health reform debate rages on, a local program to cover the uninsured is now underway in Santa Clara County, California. On March 1, Working Partnerships USA, in partnership with the Santa Clara Family Health Plan and the Santa Clara Valley Health and Hospital System launched a new health care program for low-wage workers in small businesses called Healthy Workers. The program was developed by the same coalition that created the nation’s first universal health care program for children—the Children’s Health Initiative.

Healthy Workers extends affordable, comprehensive, no-deductible coverage to small businesses and their employees in Santa Clara County. The program aims to achieve three critical goals: decrease the number of uninsured adults, strengthen the region’s health care delivery system and provide an affordable and comprehensive health plan for small businesses.

Healthy Workers targets Santa Clara County small businesses with two to 50 employees that do not currently provide health care coverage. Employees must live in the county to be eligible, work at least 20 hours per week and earn less than $18 an hour.

Healthy Workers offers a comprehensive benefit plan that includes preventative care, hospitalization, emergency coverage, prescription drugs and specialty care. Participants gain access to a broad network of public and private providers. The program will be administered by a local public agency known as the Santa Clara Family Health Plan, which currently administers multiple children’s health insurance programs.

In order for Healthy Workers to be financially feasible the cost is split between the worker ($75/month), employer ($150/month per employee) and the Santa Clara Valley Health and Hospital (SCVHHS) system, which will provide services at a discounted rate. As the county’s safety net provider, SCVHHS currently serves most uninsured adults in the county as charity care patients, receiving little or no compensation. It is thus anticipated that bringing these patients into the Healthy Workers program will result in a net fiscal benefit for the county health system, because the system will now secure some revenue for treating patients that would have otherwise been eligible for the county’s charity care program.

Healthy Workers has already received significant support from a broad cross section of local leaders, including formal endorsements from a dozen local chambers of commerce.

Healthy Workers is a collaborative effort that provides a win-win-win for low-income residents in search of an affordable health plan, the health care delivery system struggling with an increasing number of uninsured patients and small businesses who cannot find an affordable plan to offer their workforce. It represents a sustainable local coverage model that can be replicated in other regions through out the country.