Medi-Cal Expansion

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Gov. Brown’s State of the State — on the Health Care Overhaul

(Justin Sullivan/Getty Images)

In Thursday’s State of the State speech, Gov. Brown called for a special legislative session to address the Affordable Care Act. (Justin Sullivan/Getty Images)

In his State of the State speech Thursday morning, Gov. Brown spent about 60 seconds addressing health and human services — and all those seconds were devoted to the rollout of the Affordable Care Act.

Early in his speech, Brown reiterated his theme of fiscal discipline and seemed to urge caution in implementing the Affordable Care Act, stating, “The ultimate costs of expanding our health care system under the Affordable Care Act are unknown. Ignoring such known unknowns would be folly.”

Later in the speech came the bulk of his comments about the ACA. Here’s the transcript:

“California was the first in the nation to pass laws to implement President Obama’s historic Affordable Care Act. Our health benefit exchange, called Covered California, will begin next year providing insurance to nearly one million Californians. Over the rest of this decade, California will steadily reduce the number of the uninsured. Today I’m calling for a special session to deal with those issues that must be decided quickly if California is to get the Affordable Care Act started by next January. Continue reading

Analysis: Medicaid Expansion Brings ‘Minimal’ State Costs

A new report finds California could see a significant increase in Medi-Cal coverage at “minimal” cost to the state. Medi-Cal is the state’s version of Medicaid, health insurance largely for the poor. In the new study from researchers at UC Berkeley and UCLA, analysts report that 1.4 million California adults under 65 will be newly eligible for Medi-Cal. The Affordable Care Act says the federal government will pay 100 percent of the costs of these new enrollees from 2014 to 2016 and no less than 90 percent of the cost after that.

In addition, the implementation of the ACA is expected to bring many people already eligible for Medi-Cal into the fold. The state will pay a greater share of the costs for those people.

Altogether, analysts project that from 2014 to 2016, California will incur additional annual costs between $188 million and $471 million. But at the same time, billions of dollars will flow into the state, paying the overwhelming majority of total costs for the newly enrolled and those already eligible.

“This is a really great opportunity for California to enroll and offer coverage to over a million people at a very low cost to the state,” said Laurel Lucia, lead author of the study and a policy analyst at the UC Berkeley Center for Labor Research and Education. Continue reading

Expanding Medi-Cal Caseload Leaves State Concerned About Cost

(Daryl Hunt/Flickr)

(Daryl Hunt/Flickr)

The Affordable Care Act calls for an expansion of Medicaid — or Medi-Cal in California. Last week the feds were clear that states must expand to the mandated 138 percent of poverty in order to get federal funds. Feds have promised to pick up 100 percent of the costs of these new enrollees for the first three years. Expanding to 138 percent of poverty means another 1.5 million Medi-Cal recipients.

So now we know who will receive Medi-Cal benefits, but California’s Secretary of Health and Human Services, Diana Dooley has already signaled concern about being “on the hook for promising things we can’t deliver.”

In other words, the Administration is looking at limiting benefits as KPCC’s Julie Small reported this morning on The California Report. For starters, after the three years of federally-funded Medi-Cal expansion, states must pick up 10 percent of the tab — or an estimated $6 billion within the next decade, according to the Kaiser Family Foundation. While California is committed to expanding Medi-Cal, the prospect of limited benefits is a concern to advocates, including Vanessa Cajina with the Western Center on Law and Poverty. From Small’s report:

“We want to provide coverage for people that they can afford and that’s accessible and still having the question open is disconcerting at this point,” Cajina said.

Democratic lawmakers agree. San Gabriel Valley Senator Ed Hernandez – a former optometrist who chairs the Senate Health Committee – told advocates at [a recent] symposium he’s pushing to get California to offer the maximum benefits to the new group of people who qualify for Medi-cal.

“I have every intention to make sure that every single person has the fullest amount of benefits available and draw down as many federal dollars as we possible can,” Hernandez said.

Hernandez thinks California should also raise the rates the state pays providers for treating Medi-Cal patients. California ranks 47th in the nation for the lowest rates — so low that many physicians refuse to participate.

Democrats also want to reinstate some benefits cut in recent years, like dental coverage for adults. Patients can now get covered for a tooth extraction, but not for dentures.

Some Democrats believe they should use their new super-majority status in both houses to reinstate some of these benefits. Small reports that Republicans could get behind some of these ideas — but only “if lawmakers rein in Medi-Cal’s administrative costs.”

A special legislative session about the Affordable Care Act — and the Medi-Cal expansion — is expected in January.

Listen to Julie Small’s piece: