Medi-Cal Gets the Budget Breakdown…

On Monday, the Assembly Budget Subcommittee 1 on Health and Human Services, chaired by Assemblymember Shirley Weber, took up a variety of items around Medi-Cal and the Affordable Care Act, of which many were held open for further deliberation. Here’s a report by our legislative advocate Sawait Hezchias-Seyoum:

Among several items, the committee considered restoration of several Medi-Cal Optional Benefits, including adult dental services, which were eliminated as part of the 2009 Budget Act.  The Department clarified to the Committee that the restored dental benefits, that begin May 1, 2014, will be available to women in the pregnancy-only Medi-Cal program, as well as parents and childless adults newly enrolled during the expansion. This item was held open.

The Committee also deliberated on the Affordable Care Act (ACA) Pregnancy Services Proposal.  The discussion on this item was similar to the discussion that took place in Senate Budget Committee on Health and Human Services.  Health Access testified in support of a bright line at 138% FPL for full-scope Medi-Cal for pregnant women. Several groups expressed their opposition to the current wrap-around proposal due to the fact that CPSP services would not be preserved, arguing that that CPSP services provide valuable psycho social, nutritional and mental health benefits.  Other advocates urged the Committee to preserve full scope Medi-Cal, arguing that pregnant women should not be treated any different than any other person. This item was held open.

The discussion around the ACA Medi-Cal Eligibility Integration with CalHEERS garnered considerable attention, given recent reports indicating that 800,000 Medi-Cal applications have not been processed due to a system glitch.  Toby Douglas, on behalf of the Department acknowledged that the attempt to integrate the Medi-Cal Eligibility determination system with CalHEERS has not been without challenges.  Toby indicated that the Department is committed to continuing to work out the challenges they are experiencing. Advocates, including Health Access and Western Center on Law and Poverty urged the Department to explore different self-attestation alternatives as a solution to the back log of un-processed Medi-Cal applications.

The proposal to establish a Statewide Outpatient Medi-Cal Contract Drug List was another item that garnered considerable attention, as was the case when it was discussed in Senate Budget Subcommittee 3 on Health and Human Services.  The health plans expressed their opposition, citing failed attempts by other states, including Ohio and Texas. Most groups, including Health Access expressed appreciation to the Committee for holding this issue open, given the complexities that exist around the issue.

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