SAN JOSE -- Santa Clara County Supervisors Liz Kniss and Ken Yeager are engaged in a fight for the health of county hospitals after a trip to Washington D.C. last week.

The causes of concern are two policy changes that will affect payment for services provided to uninsured patients and funding for the State Children's Health Insurance Program, known as the Healthy Families program in California.

"We are fighting to keep the County health care system alive and available to the community," Kniss said, who is chairwoman of the county's Health and Hospital System Committee.

"If the recently proposed rule changes are not overturned, Valley Medical Center's revenue will decrease by an additional $32 million annually. We are doing everything we can to stop the loss of County resources."

The first issue is President Bush's fiscal year 2008 budget, which proposes cuts to Medicaid funding to public hospitals by $25.7 billion. Of that $25.7 billion, a $12.7 billion loss would come from significant changes in Medicaid policy.

Estimates for the effects of proposed rule changes on California hospitals show a decrease in federal payments of $550 million, $500 million of which would directly impact public hospitals, according to Santa Clara County spokeswoman, Gwen Mitchell.

Valley Medical Center's revenue would decrease nearly $32 million annually, the county reported.

"It is unthinkable that the federal government would single out public hospitals by putting a new restrictive rate cap on payments," Yeager said. "This cap would severely limit funds for care for the uninsured."

The second issue is the expiration of the Healthy Families program in California and the new qualification standards and funding levels proposed by Bush for the reauthorization of the program.

Bush's fiscal year 2008 budget calls to increase funding by $30 billion over the next five years and calls for a return to earlier qualification standards for children from 200 percent below poverty to 250 percent below federal poverty levels.

The county is arguing that this is not enough to cover the county's needs.

The county is recommending funding of $60 billion over five years and that qualifying children be living at or below 300 percent of the federal poverty level.

The federal government currently funds about two-thirds of the state's Healthy Families program by contributing $791 million, which is not enough according to the county.

"We want to be on record in support of the funding it will take to expand the eligibility for Healthy Families coverage in California," County of Santa Clara Supervisor Ken Yeager said. "The President's budget would effectively reduce enrollment, which is a huge step backward."

Currently, Healthy Families serves 770,000 low-income children in California and nearly 25,000 in Santa Clara County.

The overall effect of the policy changes would threaten the state and the county's ability to provide a critical health safety net for citizens.

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