Latest Morning Briefing Stories

It May Be Arcane, But It’s Also Vital

Almost everyone in the health care world knows how important the Medicaid waiver is to California — and really, to the nation.

As the first state to implement national health reform ideals on such a large scale, what happens in California by Oct. 31 with the $10 billion waiver is something that will affect how health care reform is put in place in many other states.

But not everyone in the health care world understands all of the complex give-and-take involved in so many rule changes and manipulations of the health care market.

Medicaid Waiver Big, Innovative and Worth $10 Billion

California officials hope a new agreement being negotiated now with CMS will result in about $2 billion a year in federal money for Medi-Cal over the next five years — roughly doubling the current federal contribution. They’re redesigning Medi-Cal with the aim of establishing an innovative, state-of-the-art managed health care system.

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.

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.”

Doc Shortage Made Worse by Low Participation in Medi-Cal

California faces two related problems about to get worse: not enough family practice physicians and not enough physicians treating Medi-Cal patients. We asked stakeholders how California should deal with these two shortages.

Medi-Cal Crunch Looms for Community Clinics

The budget is about seven weeks late now. Without a budget, the state can’t keep writing Medi-Cal checks to health care providers. And that budget crunch begins today, when the last Medi-Cal checks go out to community clinics throughout California.

Without that $43 million every two weeks, those clinics will be in big trouble, according to Carmela Castellano-Garcia, president and CEO of the California Primary Care Association (CPCA).

“That means clinics are not going to receive 50% to 80% of their revenue, so they’ll be in a challenging financial situation,” Castellano-Garcia said. “This budget stalemate is going to have significant impact on them.”

Welcome Back, Now Get to Work

Think the wheels of Sacramento politics move slowly? Think again.

On Monday, when the California Legislature returns from its summer recess, the Senate Committee on Appropriations plans to conduct a session that is expected to last 12 hours — and possibly longer — when it takes up and either approves or denies 203 new laws.

If you do the math, that’s just 3 minutes and 31 seconds for each bill — to introduce,  argue both sides, have questions answered and vote on each piece of legislation.

Fiscal Issues Could Put Medicaid Expansion in Jeopardy

The health care overhaul relies on a significant expansion of Medicaid to reduce the uninsured population. Budgetary pressures that have forced many states to implement cuts to Medicaid ahead of the expansion and uncertainty about federal funding have raised questions about the plan’s viability.

Medi-Cal Waiver Gets Senate Committee Approval After Unusual Third Tier of Testimony

You know you’re in murky legislative territory when the format of a health committee meeting has to be changed to accommodate the complicated nature of the proposed bill.

In this case, it was AB 342 by John Perez (D-Los Angeles), which the Senate Health Committee eventually approved at its hearing last week. It is the companion Medi-Cal waiver bill to SB 208, which recently passed the Assembly Health Committee.

Usually, committees hear pro and con testimony, but for AB 342, Senate committee chair Elaine Alquist (D-Santa Clara) made a third category. “It’s a hybrid category just for this one bill,” Alquist said. “For those who are neither opposed nor support, but have concerns.”