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Medicaid Waiver Bills Still in Play at Capitol

The legislative deadline passed more than week ago, but at least two health care bills are still at play in the Legislature.

Not only are two bills dealing with Medi-Cal waiver certain to get a vote when the legislature reconvenes to take up the budget, the legislation has several big factors in favor of its passage, according to health care expert Peter Harbage of Harbage Consulting.

“At the end of the day, the policy changes in the waiver and its funding are too valuable for California to pass up.”

Harbage said that specifics are still being worked out about exactly how much federal money would come to California, but the goal has been about $2 billion a year for five years.

“Without the waiver, you’re going to see many, many hospitals close,” he said. “The goal is to have spending of about $2 billion a year, and that would make it one of the biggest [federal waivers] ever.”

The Medicaid waiver issue, represented by AB 342 by John Perez (D-Los Angeles) and SB 208 by Darrell Steinberg (D-Sacramento), is still eligible to be heard in the legislature because it’s an urgency measure, which means it needs a two-thirds vote to pass.

The waiver has many parts, and the language and details are not yet complete. Some of the possible changes being discussed are an expansion of coverage for low-income patients not eligible for Medi-Cal (Medi-Cal is California’s version of the federal Medicaid program), and the possibility of enrolling some dual-eligible seniors and disabled, ones who qualify for Medi-Cal and Medicare. And a pilot has been proposed to provide service delivery for children who get benefits from California Children’s Services. Another possible facet of the waiver would be to foster investments for public hospitals.

“It’s a bridge to health reform,” Harbage said. “It’s a pretty big waiver, there are a lot of different aspects to it. The biggest thing is the coverage expansion — that will start to bring folks into the new Medicaid product by 2014 [when federal health care reform is implemented].”

And the investment in California’s safety net hospitals, Harbage said, will help those hospitals transition into stronger, more capable institutions.

“Safety net hospitals in California have been chronically underfunded,” he said. “The waiver funds and delivery system improvements will help make sure all hospitals are ready for health reform.”

That’s an important element, according to Harbage. “Because what we’re going to see is that demand will increase, not decrease,” he said. “This will get those hospitals up to speed for 2014.”

Related Topics

Capitol Desk Medi-Cal