California, Feds Face Off Over Proof-of-Citizenship Rules
The federal government is delaying final approval of a Medicaid agreement with California while officials debate whether the state will begin requiring proof of citizenship before they can receive birth control at no cost, the Sacramento Bee reports.
The Bush administration has been extending the current funding agreement for the California Family Planning, Access Care and Treatment program on a monthly basis while the debate continues. The current agreement is due to expire April 30.
The state currently does not require Medi-Cal enrollment for recipients of the program, which provides birth control and disease testing. The federal government does not pay for birth control for undocumented immigrants, but the state covers the estimated 14% of total costs for these recipients.
State officials say the requirement could result in more unintended pregnancies, especially among undocumented immigrants, who would be eligible for Medi-Cal-covered prenatal care and deliveries. California officials estimate that federal funding for such services would increase by at least $400 million under the proposal.
The annual cost of the program is about $450 million, and the state estimates a savings of $1.4 billion by reducing unintended pregnancies and cases of sexually transmitted infections.
State officials estimate the federal government would have to pay an additional $290 million annually to screen and enroll birth control recipients in Medi-Cal.
In addition, the federal government has cut off funding for mammograms and some screenings for sexually transmitted infections under Family PACT.
CMS spokesperson Jack Nelligan in an e-mail wrote that California should not have billed CMS for such services.
Gov. Arnold Schwarzenegger (R) has proposed continuing coverage of the services using about $2.5 million in state funds (Benson, Sacramento Bee, 4/4).