Santa Clara County more than doubled its enrollment targets for the Affordable Care Act, a.k.a. Obamacare, driving up revenue for the Valley Health and Hospital System.

County officials expected to enroll 21,500 people newly eligible for Medi-Cal under President Obama's healthcare reforms, and budgeted accordingly. But enrollment is now expected to hit 48,000 this year, driving up revenue $85.6 million more than projected.

The Board of Supervisors will vote Tuesday on a budget modification to account for the increase.

Fortunately, Obamacare reimburses the county 100 percent of the cost. The increased revenue will make up for the spike in payroll and other expenses from the influx of patients. Hospital officials want to use some of the money to update its electronic records system, buy new equipment for the oncology department and replace a fire alarm system, among other things.

Covered California, the health benefit exchange created to implement the Affordable Care Act, has enrolled 1.4 million people to date. Medi-Cal, which insures low-income residents, added 2.7 million more beneficiaries and provided coverage for more than 12 million Californians.

Before Obamacare, the county had to foot half the cost of treating uninsured patients, primarily through Medicaid waivers that picked up just 50 percent of the tab.

More from the Santa Clara County Board of Supervisors agenda for April 21, 2015:

• To save water in the thick of a historic drought, Supervisor Ken Yeager suggests replacing lawns at county-owned properties with drought-tolerant landscaping. He also proposes a decade moratorium on putting any new lawns or decorative fountains at county facilities. Last month, Gov. Jerry Brown urged local governments to replace 50 million square feet of lawns with drought-tolerant landscaping. It's possible, too, that the county could get some grants for the effort. Yeager cited Gov. Jerry Brown's directive to slash water use by 25 percent this year. “People should realize we are in a new era,” Brown said at a news conference earlier this month. “The idea of your nice little green lawn getting watered every day, those days are past.”
• A little more than 11 percent of the county's foster youth take psychotropic medications, according to a report supervisors ordered in response to a Mercury News report about the over-medication of foster kids. That evens out to about the state average, according to the county. "There has been public concern about the potential for bias towards prescribing medication," the Social Services Agency report states. "However, any bias is against prescribing medication for minors."
• The Office of Women's Policy wants the county to create a certification program that rewards companies with family-friendly policies. Under the proposal, companies would earn bronze, silver or gold according to the quality of their work-life balance, parental leave and accommodations for nursing moms.

WHAT: Board of Supervisors meets
WHEN: 9am Tuesday
WHERE: County Government Center, 70 W. Hedding St., San Jose
INFO: Clerk of the Board, 408.299.5001