Debate on Eligibility Verification Threatens Family PACT Funding
California could lose federal funding for its Family Planning, Access, Care and Treatment Program if it fails to reach an agreement with CMS officials over eligibility verification for the program, the Contra Costa Times reports.
Family PACT provides reproductive health services to people whose annual incomes do not exceed 200% of the federal poverty level.Â Federal rules limit the program to U.S. citizens and documented immigrants who have been in the country at least five years.
However, California does not verify individual program beneficiaries' eligibility for the program.Â Instead, state officials have estimated that 14% of Family PACT beneficiaries are undocumented immigrants and deducted the cost of serving those beneficiaries from the amount that the state seeks from the federal government for the program.Â
State funds are used to cover family planning services for undocumented immigrants.
The federal government covers $315 million of the program's total $432 million annual cost.
The program is credited with preventing 170,000 unplanned pregnancies each year.
Center of Debate
CMS wants California to verify the eligibility of each program applicant, a change in policy that state officials say would cost California $128 million annually for 1,300 additional employees.
In making their case for the policy change, CMS officials cite a 2005 review that found that 24% of the Family PACT beneficiaries were ineligible for the program under federal guidelines and that eligibility could not be determined for an additional 35% of beneficiaries.
More than two years ago, the state offered to increase its estimate of how many Family PACT beneficiaries are ineligible for the program, according to the Times.
Stan Rosenstein -- chief deputy director of the Department of Health Care Services, which administers the program -- said that California remains willing to negotiate the percentage but that federal officials have rejected the proposal.
State officials argue that verifying individual applications would not be cost effective for the state or federal governments.
CMS spokesperson Mary Kahn said, "The CMS officials are insisting that every enrollee be eligible because that's the law."
CMS has given the state until Friday to decide if it will verify applications individually (Kleffman, Contra Costa Times, 11/9).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.