Schwarzenegger Expected To Turn Attention to Medi-Cal Overhaul
Gov. Arnold Schwarzenegger (R) was expected on Monday to unveil a "fundamental overhaul" of Medi-Cal after signing the fiscal year 2004-2005 state budget Saturday, the Sacramento Bee reports (Benson, Sacramento Bee, 8/1). In May, Schwarzenegger said that on Aug. 2 he would release his plan to reorganize Medi-Cal, which he said would reduce state spending on the program by $400 million beginning in 2005 (California Healthline, 5/14).
According to the Bee, whether the plan will be presented Monday "is unclear" because administration officials would only confirm that they would make an announcement about Medi-Cal this week.
Schwarzenegger administration officials have discussed plans that would:
- Add monthly premiums and copayments for some Medi-Cal beneficiaries;
- Move the elderly, blind and disabled into managed care programs, which could save $100 million annually;
- Allow health care providers to deny services to beneficiaries who do not pay their premiums or copays (Sacramento Bee, 8/1).
In addition, the administration is considering a plan to reorganize $2 billion in federal money for safety-net hospitals, the Oakland Tribune reports (Vesely, Oakland Tribune, 8/1). The state must receive permission from the federal government before changes can be enacted (Sacramento Bee, 8/1).
Although the details of the administration's plans are "being kept under wraps, patient advocates, hospitals and policy analysts are concerned the changes could have adverse consequences -- and dramatically alter how millions of patients access care and who pays for it," the Tribune reports. Dave Kears, director of the Alameda County Health Services Agency, said, "There are upsides to reforming Medi-Cal, but I don't know if there will be upsides to this reform."
Ralph Silber, executive director of the Alameda Health Consortium, a network of community clinics, said he is concerned about requiring beneficiaries to pay premiums because "[p]remiums in some way are even more insidious (than copays) because lots and lots of poor people won't be able to pay them and will fall off the rolls." Silber said that expanding enrollment of Medi-Cal beneficiaries in managed care plans could improve their quality of chronic disease management, prescription drug benefits and health education, the Tribune reports. However, Silber said that the targeted beneficiaries are "among the sickest," and enrollment in managed care plans could impede access to physician appointments and prescription drugs (Oakland Tribune, 8/1).
Assembly member Darrell Steinberg (D-Sacramento) said, "We all ought to judge these reforms not only by whether or not they save money, but also on whether these efficiencies increase access to health care" (Sacramento Bee, 8/1).