Proposed Medi-Cal Funding Agreement Includes Provisions on Expanded Coverage, Managed Care
California would have to create a new health coverage program for uninsured residents and expand utilization of managed care plans for some Medi-Cal beneficiaries, according to the latest version of an agreement on Medi-Cal funding being negotiated by members of Gov. Arnold Schwarzenegger's (R) administration and federal officials, the Sacramento Bee reports.
Under the proposal, the federal government would provide $180 million in each of the last three years of the five-year agreement if the state implemented a coverage expansion program and provided matching funds.
In addition, the agreement would require the state to enroll more elderly California residents and those with disabilities in managed care plans, but those provisions have been rejected in a budget conference committee. According to the Bee, California could lose $360 million in federal funding over the next two years if the Legislature rejects the managed care provision of the agreement.
The deadline for completing the proposal is June 30.
Stan Rosenstein, deputy director of medical care services for the Department of Health Services, said the plan would give the state increased flexibility to determine how to expand coverage. He added that the uninsured would have an opportunity "to get out of expensive inpatient care and get into utilizing more primary and preventive care to improve their health status and avoid high-cost hospitalizations."
Critics have said the plan "would attach strings" to funding that public and private safety-net hospitals need to treat uninsured patients, the Bee reports.
Counties and hospitals have expressed concern about the plan to Schwarzenegger. The heads of several state hospital associations last week in a letter to the governor said that "some public and private safety-net hospitals would close" under the plan (Benson, Sacramento Bee, 6/12).
In related news, Schwarzenegger on Thursday signed AB 65, by Assembly member Lynn Daucher (R-Brea), addressing Medi-Cal benefits (Office of the Governor release, 6/9). The law allows any county or counties to establish a special commission to address problems related to the delivery of publicly funded medical care, including Medi-Cal and Medicare (Bill text, 5/31).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.