Today, the Assembly Budget Subcommittee on Health and Human Services, chaired by Assemblywoman Holly Mitchell, considered the proposed funding for the Managed Risk Medical Insurance Board–which runs programs like Healthy Families, Access for Infants and Mothers, and the high-risk pools MRMIP and PCIP.
They considered the question of whether to eliminate MRMIB, and shift all its programs to the Department of Health Care Services. In particular, most of the discussion was on the future of the Healthy Families program, which covers nearly 900,000 children from 100-250% of the federal poverty level. The Governor’s budget proposes to shift all Healthy Families children into Medi-Cal, under the Department of Health Care Services. Additionally, it would make a 25% rate reduction to plans for covering Healthy Families children, to align with the Medi-Cal rate, from $103/child to $77/child.
As we recounted on http://www.twitter.com/healthaccess, the committee got lots of input. Toby Douglas, director of Department of Health Care Services, made the case for the transfer, citing the shift would streamline state government to be ready for the implementation of the Affordable Care Act. They said the “lift and shift” proposals would make no changes in how the programs were staffed or managed, at least initially.
But legislators, including Assemblyman Wes Chesbro, had several questions, especially regarding whether these children will maintain access to providers, especially in rural areas.
Virtually all the comments from a long line of testimony raised significant concerns and opposition to the shift, from children’s and community groups, medical providers, and health insurers. One area of support was starting with a smaller population–children under the “bright line” of 133% of the poverty level, which would be under Medi-Cal in 2014 under the Affordable Care Act anyway.
Ultimately, after all the discussion, that’s the action the Subcommittee took: Approving the transfer of the 183,000 children up to 133% of the poverty level in the 2012-13 budget year, but under the condition of adequate planning and monitoring, and that such a transfer only start 60 days after a full transition plan is approved, that considers access, continuity of care, and a range of other issues.
Other issues were held open until after the May Revise, including the elimination of MRMIB in 2013; and the 25% proposed rate reduction. As always, no decision is final until the budget is signed.