Little Concern About Waiver Timing

When the state Assembly and Senate gather to vote on a budget for California — whenever that may be — members will also vote on the $10 billion Medicaid waiver.

The Medicaid waiver is the plan California has laid out in months of negotiations with CMS to implement the revised Medi-Cal program in California, and to prepare the state for health care reform.

Since California is ahead of the national curve on getting set for the health care reform law, many other states are watching what happens here — which puts additional pressure on federal approval of this large and innovative waiver plan.

Originally, the waiver was supposed to be finalized by Aug. 31, but federal officials recently approved a 60-day extension, so the new deadline for approval is Oct. 31.

So, for California to change state law to accommodate the agreed-upon waiver rules, the Legislature needs to pass two bills: AB 342  by John Perez, (D-Los Angeles) and SB 208  by Darrell Steinberg (D-Sacramento), which would authorize the Department of Health Care Services to implement the agreement made with CMS.

Ssince those two bills have urgency status and require a two-thirds vote, and since they will come up during the possibly contentious budget vote, there has been some concern that a long delay in the budget could somehow derail the waiver vote.

“That is not likely,” health care consultant Peter Harbage said. “If [the waiver vote] is somehow delayed, you could get an extension.”

Harbage said he doesn’t see California lawmakers voting down the waiver that  could represent approximately $2 billion a year to California for the next five years. An estimated $1 billion of that would be new money — that is, money for programs that were not in the previous Medicaid waiver.

“The state will need to change the laws, in relation to what the feds want them to do,” Harbage said.

That feeling was echoed by Department of Health Care Services deputy director Gregory Franklin. “We’re moving as if we’re going to get approval,” Franklin said.

Related Topics

Capitol Desk Medi-Cal