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Breaking News: CA Budget Deal Includes Historic Kids Expansion; But Not Other Medi-Cal Restorations

Pictured above: Beth Capell for Health Access, Senator Ricardo Lara (author of SB 4), and Ronald Coleman of the California Immigrant Policy Center.

Big Step Forward on #Health4All

Today in a joint press conference with California Assembly Speaker Toni Atkins and Senate President Pro Tempore Kevin de León, Governor Brown announced a budget deal that includes $40 million for a Medi-Cal expansion for low-income children regardless of immigration status. The expansion would be effective May 1, 2016 (four month later than the Legislature’s proposed start date). The proposal would eventually cover 170,000 children and cost $132 million when fully implemented and the full number of children expected to actually enroll.

This expansion of coverage to all children regardless of immigration status would make California’s children healthier, our health system stronger, and our families and communities more financially secure. Ensuring all California children, regardless of immigration status, have access to primary and preventive care, advances the effort to improve the quality and reduce the cost of the health system on which we all rely. We thank the Governor and legislative leaders for taking this next step for a health system that works for all Californians. While Washington continues to see gridlock on immigration and health issues, this proposal would continue California’s leadership in both health reform and immigrant inclusion. California will be the largest state to make this commitment to cover all its children (along with NY, IL, WA, MA and DC), regardless of where they were born, and we expect additional steps in short order.

A related bill SB4 would make California the first state in the nation to expand Medi-Cal to undocumented immigrants (up to a capped amount set in the California budget), and allow undocumented immigrants above those income levels to use their own money to buy a health plan in Covered California. This bill will soon be heard in the Assembly Health Committee.

Key Health and Human Service Cuts Not Restored In Budget Deal

The budget deal did not fully restore Denti-Cal or other recession-era cuts to medically necessary Medi-Cal benefits like audiology, speech therapy, or podiatry. The Legislature’s budget sought to restore these benefits, as well as to begin the restoration of Medi-Cal provider rate reimbursements which were cut by 10% several years ago.

We still have more to do to restore the health and human services cut during the recession. The cuts made during the recession were penny-wise but pound-foolish, cutting services like dental and podiatry, and access to primary and preventive care. California needs to continue to work on these restorations to provide more efficient and cost-effective care overall.

There may be opportunity to look at these issues, though in the much larger context of Medi-Cal financing. The Governor used his press conference to call for a special session to address financing of the Medi-Cal program in general and in light of both regulatory changes in allowable uses of federal matching funds and the dramatic increase in enrollment from the Affordable Care Act (see the Governor’s special session resolution on this topic). The special session may be an opportunity to revisit these restorations of Medi-Cal rates and benefits and to address access issues in general.

The budget deal came on the same day as a state audit of Medi-Cal showing there is still significant work to ensure that the 12 million Californians with Medi-Cal coverage have access to needed services and care. Specifically, the audit finds that DHCS did not verify that the provider network data that it received from the plans were accurate, which means that DHCS cannot ensure adequate access to providers for Medi-Cal beneficiaries. These findings provide momentum for pending reforms, including implementation of annual surveys of network adequacy through SB 964 (Hernandez), which passed last year, and consideration of SB137 (Hernandez), which is pending in the California Assembly.  SB137, co-sponsored by Health Access, Consumers Union, and CPEHN, addresses the problem of inaccurate, out-of-date, and misleading provider directories.

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