Gov. Brown, Democrats Disagree Over Medi-Cal Expansion Plans
Gov. Jerry Brown (D) and Democratic state lawmakers disagree over how to expand Medi-Cal under the Affordable Care Act, the Los Angeles Times reports.
Medi-Cal is California's Medicaid program (Mishak, Los Angeles Times, 3/9).
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.
The federal government will fund the expansion for the first few years, according to the ACA (California Healthline, 3/7).
Last week, the state Assembly and Senate passed companion bills (SBX1-1 and ABX1-1) that would expand Medi-Cal eligibility to more than one million Californians. The bills also would simplify the Medi-Cal enrollment process (Gorn, "Capitol Desk," California Healthline, 3/8).
Brown, Democrats at Odds
Brown seeks to scale back certain Medi-Cal benefits that Democratic lawmakers want to include as part of the expansion, such as long-term care for residents with disabilities.
In addition, Brown's plan for the expansion would move certain groups now covered by Medi-Cal -- including certain patients with AIDS, as well as recent documented immigrants -- to the state health insurance exchange. Democrats want the groups to remain eligible for Medi-Cal coverage.
Brown also has proposed paying for the Medi-Cal expansion by reducing the roughly $2 billion that the state provides counties annually to pay for treatment of uninsured individuals. However, Democrats argue that the reduction is unnecessary because the federal government will fund the expansion for the first three years.
According to Brown, the state should include a "trigger" in Medi-Cal expansion legislation that would cancel the initiative if the federal government stops paying at least 90% of the cost. Democrats oppose the trigger and instead would give the Legislature up to one year to reevaluate and amend state laws if federal funding changes.Although Democrats and local officials want the state to administer the Medi-Cal expansion instead of counties, Brown has not yet endorsed either strategy (Los Angeles Times, 3/9). 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.