Brown, Democrats At Odds Over Medi-Cal, Indigent Care Funding
California Democrats and Gov. Jerry Brown (D) are at odds over how to expand Medi-Cal under the Affordable Care Act and provide indigent care funding to counties, the Los Angeles Times reports.
Medi-Cal is California's Medicaid program.
Disagreement Over Medi-Cal Expansion
Compared with Brown's fiscal year 2013-2014 budget proposal, Democrats in the Legislature want to expand Medi-Cal coverage to more residents and reimburse physicians and hospitals participating in the program at a higher rate.
Assembly member Holly Mitchell (D-Los Angeles) said that "[e]veryone is on the same page" regarding the Medi-Cal expansion, adding, "It's the governor who seems to be out of the loop" (York/Megerian, Los Angeles Times, 5/10).
Disagreement Over County Indigent Care Funding
Brown's budget plan earmarked $350 million to cover the increased enrollment in Medi-Cal.
The federal government will fund the expansion for the first few years, according to the ACA. Brown has said that the state might try to cover subsequent costs by reducing the roughly $2 billion it provides counties each year to cover health care services for uninsured individuals.
Toby Douglas -- state director of health care services -- said that counties should relinquish some of their indigent care funds because the Medi-Cal expansion "has to be sustainable in the long haul."
However, county officials have expressed concern that such proposals to reduce their funding could have a negative effect on their safety-net health care facilities.
Mitchell Katz -- director of the Los Angeles County Department of Health Services -- said state indigent care funding already does not cover county costs for providing such treatment. He added that counties still will have significant indigent care costs following the Medi-Cal expansion for individuals who still will not qualify for coverage (California Healthline, 3/7).Brown is expected to release a revised budget proposal on Tuesday (Los Angeles Times, 5/10). This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.