In a decision released today, Fresno Superior Court Judge Jeff Hamilton issued a writ directing Fresno County to stop denying health coverage in its Medically Indigent Services Program (MISP) to low-income people who can’t afford the cost of their medical care.  MISP is the County’s health coverage program for residents who can’t afford the cost of their own care and aren’t eligible for health coverage through another source like Medi-Cal or an employer.  Fresno resident David Piercy was denied MISP in 2008 when his income was $24 over the limit but not enough to pay for his medical care.   The Western Center on Law & Poverty, with co-counsel Central California Legal Services and Skadden Arps Slate Meagher & Flom, filed a lawsuit on Piercy’s behalf in September 2008, challenging MISP eligibility limits that then denied care to those with incomes over $509 per month (for an individual).

In February, the Fresno County Board of Supervisors raised eligibility levels significantly, but retained an upper cap on care that denied MISP eligibility to County residents who earned more than $1788 per month (for an individual).  Judge Hamilton ruled that the County’s eligibility cap is unlawful because it excludes some eligible people who cannot afford their care.  He noted that, when it adopted the cap, the Fresno County Board of Supervisors had evidence before it that indicated that some Fresno residents, despite earning incomes above the cap, would not be able to afford the full cost of the medical care they need. Judge Hamilton ordered the County to revise its eligibility policies to make sure that the policies don’t exclude applicants based solely on their income.  The County must devise a more flexible policy that takes account of the cost of applicants’ medical care and the resources available to them. When implemented, this decision will make thousands of low-income Fresno residents potentially eligible for the County’s health program, and will prevent them from incurring huge debts to pay for medically necessary care.