Senate Budget Subcommittee Report…

A report on Senate Subcommittee #3 on Health and Human Services, chaired by Senator Ellen Corbett, written up by our legislative advocate Sawait Hezchias-Seyoum:

The Senate Budget Subcommitee on Health and Human Services met yesterday and took up a variety of items, including the Bridge Plan, elimination of MRMIB, Pregnancy Coverage, Medi-Cal Expansion Workload, and the Individual Mandate Workload under the Department of Managed Health Care (DMHC), a Statewide Outpatient Medi-Cal Contract Drug List and Adult Dental.

During the hearing, DMHC rescinded their request for positions to support their work on the Bridge Plan arguing that they are still waiting to receive federal approval to move forward and at this time are focusing their efforts on other pressing issues around ACA implementation. They did seek approval of additional staff and resources for other ACA related implementation as well as the Medi-Cal managed care expansions.

On the elimination of the Managed Risk Medical Insurance Board (MRMIB), Senator Monning expressed the need to preserve current programs to address the remaining uninsured issue. Health Access concurred with Senator Monning and reminded the Committee that there will be a number of uninsured individuals, both undocumented and individuals who failed to sign up for health coverage during open enrollment. The LAO amusingly referred to the elimination of MRMIB and transfer of its programs to the DHCS as a “lift and shift”, but raised concerns that oversight and accountability would be lost with the elimination of the MRMIB board.  The Department committed to working on this to uphold transparency, accountability through a variety of ways, including consumer engagement. This issue was held open and not voted on.

Many advocate groups weighed in on the pregnancy only proposal. 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.  Finally, DHCS closed by announcing they are working on an analysis that compares birth outcomes in pregnancy only Medi-Cal and in private insurance. The item was held open.

There was a lot of discussion around Medi-Cal Eligibility and Enrolment.  Health Access, Western Center on Law and Poverty and others expressed concern around the fact that nearly 670,000 Medi-Cal applications have not been processed, several hundred thousand due to issues with paper verification of residency and income.  In response to the Committee’s inquiry, the Department said that they are working to address the back log by allowing for self-attestation of the current applications that are pending and any new applications through April.  The Department also expressed they would allow for presumptive eligibility for children and would refer adults who are in need of urgent care to their County Human Services Department for care.

The proposal to establish a Statewide Outpatient Medi-Cal Contract Drug List was probably one of the more contentious items discussed next to Pregnancy Coverage.  The health plans expressed their opposition, citing failed attempts by other states, including Ohio and Texas. From Health Access’ standpoint, the Administration’s proposal does not make much sense, keeping in mind that the point of Medi-Cal managed care was to get the purchasing power of the plans.  It appears, based on the proposal being considered that the Administration failed to account for the reduction in drug rebates when estimating savings from managed care.  Most groups, including Health Access expressed appreciation to the Committee for holding this issue open, given the complexities that exist around the issue.

The restoration of Adult Dental benefits in Medi-Cal, which was approved in the budget last year, was discussed at length. Advocates, including Health Access and Western Center on Law and Poverty expressed their support of more data around access and utilization and further urged the Committee to consider full restoration of adult dental.

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