SAN DIEGO —— Moving to try to appease a Superior Court judge who says the county is illegally denying medical aid to thousands of poor people, county supervisors voted to increase the monthly income limit they have used to approve and deny access to the County Medical Services program Tuesday.

However, county leaders immediately said the move would force the county to cut services to other needy people to come up with $6 million —— the amount that hiking the income limit would add to the cost of the $60 million-per-year medical services program.

Meanwhile, attorneys representing several people to whom the county refused treatment said they would immediately object to the new county plan, and would ask the courts to reject it.

Superior Court Judge Ronald Styn ruled last month that the county could not legally use a "strict income limit" to approve or deny access to the county medical services program.

The county is required by state law to offer the program as a "safety net" to provide health care treatment to poor adults who cannot get it anywhere else.

On Tuesday, Katie Murphy, an attorney for the Los Angeles-based Western Center on Law & Poverty, said the county's action to increase its revenue limit from $802 per month to $1,078 per month flew in the face of Styn's ruling.

Murphy represents several people who sued the county in February over the medical services program —— including a North County woman who said her cancer progressed from treatable to inoperable after the county rejected her request for medical help.

Murphy said if the county rejects a person because they earn more than $1,078 a month, it had the "same problem" as rejecting them for making $802 a month. Both figures are income limits, which the judge ruled illegal.

John Sansone, the county's main attorney, said he believes that Styn may accept the new standard because the county "considered people's ability to pay" —— rather than setting a strict income limit for eligibility. The $1,078 figure considered San Diego County's "cost of living" expenses.

Murphy, however, said the county's "cost of living" figures had flawed numbers and that the new limit should be much higher. For example, she said, under the county's figuring, all people in San Diego County should be able to get housing for $497 a month, when actual rents are much higher.

When Styn issued his ruling, he directed the county to return with a different plan for his review. Sansone said Tuesday that he would forward the increased limit to Styn. But he said the courts would probably not be able to review the plan until January.

Meanwhile, supervisors and county Chief Administrative Officer Walt Ekard used the issue Tuesday to blast the state over requiring the county to offer the medical services program —— without offering financial support.

"I think it's outrageous that the state has a long-standing law on the books that requires county governments to pay for these state mandates," Supervisor Dianne Jacob said. "We're already paying $60 million. How much more are we going to have to pay? Where's that money going to come from?"

Ekard and others said the only way the county could cover the increased cost would be to slash other programs for "needy" people, and that he would come back to the board with recommendations.

"We're not printing money in San Diego County," Ekard said. "Clearly, we're talking about health and human services dollars here. We're talking about services to kids, seniors, the poor and disabled."

Murphy rejected that claim.

"It was extremely discouraging to me that the entire conversation revolved around where else they could make cuts," she said. "They could come up with other revenue sources. I'm hopeful they'll look at other options."

Contact staff writer Gig Conaughton at (760) 739-6696 or gconaughton@nctimes.com.