County, State Officials Reach Agreement on Expanding Medi-Cal

After months of debate about how to fund an expansion of Medi-Cal, lawmakers and county officials have agreed on a formula for splitting the costs, KPCC's "KPCC News" reports (Small, "KPCC News," KPCC, 6/13).

Background

Under the Affordable Care Act, an expansion of Medi-Cal would allow individuals with incomes up to 138% of the federal poverty level, or $15,415 annually, to gain coverage. Medi-Cal is California's Medicaid program.

The federal government will fund the expansion for the first few years.

Gov. Jerry Brown (D) has said that the state should try to cover costs in subsequent years by reducing the amount it provides counties each year to cover health care services for uninsured individuals.

County officials have expressed concern that such proposals could have a negative effect on their safety-net health care facilities (California Healthline, 6/6).

Details of Agreement

Farrah McDade-Ting, an analyst with the California State Association of Counties, said that under the agreement -- which is still being finalized -- county officials would collectively pay back $300 million in state funding for indigent care in 2014.

Counties then would be able to choose from two options:

• A 60-40 split of any savings, with the state receiving the higher amount; or
• A more precise calculation of how much counties save from residents enrolling in Medi-Cal based on how much counties spent on indigent care over the past four years.

Next Steps

County officials still must finalize the language of the budget trailer measure. Lawmakers could vote on the measure as early as Friday, according to McDade-Ting ("KPCC News," KPCC, 6/13).