Governor’s Plan for Medi-Cal Reform Seeks To Balance Growth, Cost Concerns
The Sacramento Bee on Sunday examined efforts to reform Medi-Cal's "tangled bureaucracy and complex rules [that] often work against the people [they are] designed to serve." According to state officials, Gov. Arnold Schwarzenegger's (R) proposal would aim to let the program grow, while making some "extreme" reductions in the face of an estimated $7 billion state budget deficit, the Bee reports.
Health and Human Services Agency Secretary Kimberly Belshe said a budget proposal likely would seek to "contain costs, maximize efficiencies (and) stretch the dollar as far as possible while at the same time maintaining essential services." Schwarzenegger's proposal also includes efforts to increase the use of managed care plans and consolidate application processes online, Belshe said. In addition, the administration plan would have some beneficiaries make contributions to the cost of care and could call for some benefit cuts, according to Belshe.
According to David Topp, assistant secretary at HHSA, the agency is "definitely looking at" efforts to improve services that would allow residents of nursing homes to live on their own, and could be less expensive than nursing-home care.
In addition, state officials are negotiating with the Bush administration over how hospitals receive payments under Medi-Cal. Currently, charges incurred by hospitals for treating Medi-Cal beneficiaries and the uninsured are paid by the state, but one proposal under consideration would make counties responsible for such costs.
Critics of Schwarzenegger's plan say he is favoring the health care industry rather than the low-income residents Medi-Cal is intended to help.
Pat McGinnis, director of the not-for-profit California Advocates for Nursing Home Reform, said, "So far, everything seems to be from the provider perspective from this administration. If we're going to retain the current utilization of Medi-Cal, does that mean people are going to be cut out of the system? I think they're going to make it harder for people to get Medi-Cal in the first place."
Angela Gilliard of the Western Center on Law and Poverty said, "There are ways to improve the program that are not harmful to people who need to use medical services. Our concern is that the state's motivation is not to improve the program but to save money in a program that is already pretty cost efficient."
Topp said, "Our efforts to make the program as efficient and effective as possible protect the beneficiaries and benefit the taxpayer as well."
According to the Bee, the "debate will unfold ... next year as federal lawmakers are considering cutting Medicaid to trim the federal deficit," which "could squeeze California even more" (Benson, Sacramento Bee, 12/12).