Santa Clara County's health system wants to replace its low-cost primary care program for uninsured adults with a wider plan called Valley Care, starting Jan. 1, 2027. The Board of Supervisors takes up the change at its 9:30 a.m. meeting Tuesday.
The current Primary Care Access Program, known as PCAP, offers primary and preventive care through county clinics and community health centers to uninsured adults 19 and older with household incomes up to 650% of the federal poverty level. Membership has more than tripled over the past year, reaching 4,537 by August, according to a report from Paul Lorenz, chief executive of Santa Clara Valley Healthcare.
The report ties that growth to the federal budget law known as H.R. 1, state health care cuts and the end of enhanced premium tax credits for Covered California, and says many more coverage changes take effect Jan. 1.
What Valley Care would cover
Valley Care would cover primary, specialty, emergency and hospital care plus pharmacy, delivered through the county's hospitals and clinics, with community health centers still providing primary care. It would be open to uninsured county residents up to 650% of the poverty level who cannot get Medi-Cal, Medicare or other coverage, plus residents under 400% who cannot get subsidized Covered California plans.
People who qualify for Medi-Cal or Covered California would be steered to those first.
There would be no monthly premium. Instead, patients would pay set fees by income:
- Below 200% of poverty level: $5 for specialty or urgent care, $15 for an emergency visit, $45 for a hospital stay
- 201% to 400%: $25, $50 and $150
- 401% to 650%: $35, $100 and $300