The federal health reform law could expand Medi-Cal eligibility and enrollment to cover as many as 10.5 million Californians by 2019, according to a new report by the California Budget Project, "California Watch Blog" reports. Medi-Cal is California's Medicaid program.
The health reform law allows Californians with annual incomes at or below 138% of the federal poverty level to enroll in Medi-Cal starting in 2014.
Adding Up the Medi-Cal Growth
Medi-Cal currently covers more than 7 million state residents. The CBP report predicts that the program will grow over the next nine years to cover an additional:
- 1.5 million residents through regular program growth;
- 1 million Californians who previously were not eligible for Medi-Cal;
- More than 500,000 residents who currently are eligible for Medi-Cal but are not enrolled in the program; and
- More than 300,000 children who currently are enrolled in other public programs.
Funding the Expansion
The report predicts that the Medi-Cal expansion will cost about $37.1 billion between 2010 and 2019, with the federal government covering the bulk of the expansion costs. According to the report, California will receive more than $6 from the federal government for every dollar it spends on Medi-Cal.
Between 2014 and 2016, federal funds will entirely cover the cost of enrolling newly eligible adults in Medi-Cal. Federal payments will decline over subsequent years to cover 90% of coverage costs by 2020 and thereafter.
Some Concerns Linger
Although the Medi-Cal expansion will reduce the number of uninsured Californians, it also raises concerns about access to physicians and reimbursement levels, according to "California Watch Blog."
Many California physicians do not participate in Medi-Cal. A recent report from the California HealthCare Foundation found that about 25% of California physicians provide care for about 80% of the state's Medi-Cal beneficiaries. CHCF is the publisher of California Healthline.
The CHCF report also noted that California has one of the lowest Medicaid reimbursement rates in the nation.
The federal health reform law aims to increase physician participation in Medi-Cal. Between 2013 and 2014, the law requires states to provide Medicaid reimbursements at Medicare rates for comparable primary care services, with the federal government covering the difference in costs. States will have the ability to determine reimbursement rates following the two-year period (Lin, "California Watch Blog," 10/27).