Update on #CABudget: Deal Restores Medi-Cal Benefits & Increases Provider Rates, but Lacks Eligibility Expansions

Today, California policymakers finalized details of a 2017-18 State Budget deal which includes key improvements in the Medi-Cal program including restored benefits, increased provider reimbursements, and enhanced dental coverage. These long-sought investments, many made possible by new Proposition 56 tobacco tax dollars approved by voters last November, will help improve access to care for the 14 million Californians with Medi-Cal coverage.

While Congress considers cruel cuts and caps to Medicaid, California is showing a stark contrast in investing in this core health care program, called Medi-Cal in our state, that covers over a third of California and is central for the health system on which we all rely.

Our updated Health Access budget scorecard details the various Medi-Cal proposals that were under consideration, including ones not funded, such as expanding eligibility to excluded populations, including certain aged and disabled patients, and the #Health4All proposal to expand Medi-Cal to young adults regardless of immigration status.

ON BENEFITS: It was already announced last week that this budget will restore dental and optical benefits by 2020. Dental and nine other benefits were cut during the Great Recession of 2009. Advocates argued that after eight years of economic recovery, it was long past time to restore these benefits and especially to improve access to oral health, which is so critical to everyday living, eating, and employment. Denti-Cal was only partially restored in 2013, covering primary and preventive care and full dentures. The new budget includes funding to cover gum treatments, rear root canals, and partial dentures beginning January 2018.

The budget deal also restores optical services in Medi-Cal, starting on a longer time frame of January 2020. Advocates will continue to seek restoration of other services not covered under this budget, including podiatry, psychology, and speech therapy.

ON PROVIDER RATES: Under this budget deal, the new revenues from the tobacco tax finally allow California to improve reimbursements to dental, family planning, and other physician and specialists, with the goal of increased access for patients. In the proposed budget deal, these supplemental payments could be up to:

  • $325 million for physician payments
  • $140 million for dental care providers
  • $50 million for family planning including Planned Parenthood
  • $27 million for care for the developmentally disabled
  • $4 million for HIV/AIDS care

The structure of these payments will be determined by the Department of Health Care Services by the end of July 2017, and the Department of Finance can authorize up to $800 million in the following fiscal year, depending on the economic outlook and other factors. Health Access and other consumer and patient advocates will be working with the Administration to make sure we get the best bang for the buck in actually increasing access to care.

ON LACK OF ELIGIBILITY EXPANSIONS: Thousands of California youth are disappointed that they will continue to be excluded from full Medi-Cal coverage. Both the Assembly and Senate sought, unsuccessfully, to extend Medi-Cal to all income-eligible Californians up to the age of 26, regardless of immigration status, to help tens of thousands of young adults start out their lives. After California’s expansion to cover all children last year (SB75 or #Health4AllKids), it’s unfortunate that we’re going to let thousands of children turn 19 this year and lose their health coverage because they are excluded from Medi-Cal due to immigration status. Before the ACA, young adults were the age group most likely to be uninsured, because they are likely still pursuing education and starting out in jobs that do not provide health coverage. Even after the ACA was implemented, undocumented young adults often do not have parents with insurance to get covered under, nor access to Medi-Cal or other programs.

Also remaining unfunded was the proposal to raise Medi-Cal eligibility for the aged and disabled to 138% of the federal poverty level, to align with virtually all other adult populations in the program.

Comments are closed.