Brown Seeks Broad Authority on States’ Expansion of Medicaid
On Saturday, Gov. Jerry Brown (D) expressed concern about the state's ability to control costs as it expands Medi-Cal coverage under the Affordable Care Act, the Sacramento Bee's "Capitol Alert" reports. Medi-Cal is California's Medicaid program.
Brown -- who was joined by Diana Dooley, California Health and Human Services Agency secretary -- spoke to reporters in Washington, D.C., at a National Governors Association meeting (Siders, "Capitol Alert," Sacramento Bee, 2/23).
Under the ACA, the Medi-Cal expansion would affect individuals with incomes up to 138% of the federal poverty level -- or $15,415 annually.
Brown's fiscal year 2013-2014 budget proposal earmarked $350 million to cover the increased enrollment.
Under the ACA, the federal government will fund the expansion for the first few years.
However, a recent Legislative Analyst's Office report found that state spending on the expansion by 2021 would be between $300 million and nearly $1.4 billion annually.
The report stated, "Expansion costs are subject to substantial uncertainty."
The report also found that savings that would result from insuring as many as one million more low-income residents would offset the expenses (California Healthline, 2/20).
Brown previously has warned that federal funding for the Medi-Cal expansion might be at risk during federal deficit negotiations, even though the Obama administration has indicated that Medicaid funding will be protected.
Details of Brown's Comments
At the governors' meeting, Brown said that California is a "willing and eager" participant in health reform, but there are many uncertainties about moving forward.
He said, "[W]e have to be able to manage the program," adding, "[W]e have to know that when costs grow in certain ways we have to be able to curb them with a broad authority unconstrained in the way the federal government likes to constrain states."
His remarks come a year after the state unsuccessfully lobbied federal officials for authority to enact cuts to Medi-Cal reimbursements ("Capitol Alert," Sacramento Bee, 2/23)
Brown said he hopes to "build support among the governors for an appropriate state rule in the Medicaid expansion," adding that it is "absolutely critical that states have the authority they need to manage this very complex and expensive program."
Brown and other governors will meet with President Obama at the White House on Monday (York, Los Angeles Times, 2/23).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.