California Pushes Ahead with Medi-Cal Expansion

California Pushes Ahead with Medi-Cal Expansion

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SAN FRANCISCO – Gov. Jerry Brown signed a $96.3 billion budget bill yesterday that transfers more education money to poor and English-learning students and allows more than a million low-income people in the state to get health care insurance, under an optional provision in the Affordable Care Act.

By signing the spending bill, which contained a provision to expand Medi-Cal, the state’s name for the low-income health program known as Medicaid in the rest of the nation, Brown saved 1.4 million people who “are one illness away from bankruptcy,” noted Health and Human Services Agency Secretary Diana Dooley at a teleconference media briefing June 27, shortly after the budget bill was signed.

“They are a segment of the population that are so much in need of health care,” said Senator Ed Hernández (D-West Covina), who sponsored legislation expanding services under a broader Medi-Cal expansion bill to include mental health and substance abuse issues. The Medi-Cal expansion bill was sponsored by Assembly Speaker John A. Pérez (D-Los Angeles).

Of the 1.4 million who’ll benefit, two-thirds will be from communities of color and one-third speak English less than well, according to the Oakland-based non-profit California Pan-Ethnic Health Network (C-PEHN).

Among other things, the bill does away with many of the barriers that prevented people from enrolling in Medi-Cal, the federal-state funded health insurance program, said Elizabeth Landsberg, director of Legislative Advocacy with the Western Center on Law and Poverty. For one thing, there will no longer be an asset test for enrollees. For another, childless adults will be allowed to enroll.

“While we didn’t get everything we wanted, these bills go the extra mile to provide health care” to thousands of low-income people, Landsberg said.

One of the things health care advocates are disappointed about is that Brown made good on his threat to reduce funding to counties for indigent care, on the assumption that poor people will either sign up for Medi-Cal or purchase insurance on Covered California, the federally funded online health insurance exchange that will be launched Jan. 1, 2014. Brown has cut $300 million in county funding for fiscal year 2013-14.

“But nobody knows how many indigent people will enroll in those programs,” observed Ellen Wu, C-PEHN’s executive director.

The California Endowment (TCE), a private statewide health foundation, is playing a major role in the outreach and enrollment in the Medi-Cal expansion program, as well as Covered California, by providing around $26 million to the state, which will apply for a federal match to cover the $53 million projected cost, noted Daniel Zingale, senior vice president of the endowment.

TCE will also provide the state another $52 million over a three-year period to help it increase its health care workforce, especially in medically underserved areas.

Panelists at the briefing noted that California has been in the forefront in the implementation of the health care reform law, and Gov. Brown’s budget bill will allow it to remain ahead of the nation.

Because of the head start the state has had, thanks to its early expansion of Medi-Cal through such programs as the county-run Low Income Health Program, hundreds of thousands of people will seamlessly transit into Medi-Cal come Jan. 1, 2014, noted Anthony Wright, executive director of Health Access California, the statewide health consumer group.

“We are doing things that the rest of the nation can follow,” he said.

As of now, 26 states are participating in Medicaid expansion, while 13 have indicated they will not, according to the National Health Law Program, the non-profit that protects the health rights of poor people. Of the remaining states, four are pursuing alternate models, one is leaning toward participating and six have indicated a likelihood of not participating.

California is scheduled to begin enrolling people into Medi-Cal and Covered California in the Fall.