Calif. Democrats at Odds Over Scope of Medi-Cal Expansion Under ACA

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California Democrats are at odds over how large the state should make its expansion of Medi-Cal under the Affordable Care Act, KPCC's "KPCC News" reports.

Medi-Cal is California's Medicaid program (Small, "KPCC News," KPCC, 12/10).

Background

Under the reform law, states have the option of expanding Medicaid coverage to individuals with incomes of up to 133% of the federal poverty level. The law’s Medicaid expansion provision also will expand coverage to low-income adults who have no children (California Healthline, 7/16).

The federal government has given states the option of offering less comprehensive benefits to new beneficiaries and making the pool smaller.

Medi-Cal currently enrolls nearly eight million beneficiaries.

If California implements the full expansion, it could offer coverage to 1.5 million more residents.

Scope of Expansion

According to "KPCC News," Gov. Jerry Brown's (D) administration appears to be backing away from efforts to implement a full expansion.

At a recent symposium, Diana Dooley -- secretary of the state Health and Human Services Agency -- said, "[I]f we disappoint early because we didn't go as far as people want, it's because we have to build this on a solid foundation and be ready to make it real over the long term."

However, certain Democratic leaders are seeking a full expansion, according to "KPCC News."

Senate Health Committee Chair Ed Hernandez (D-West Covin) said, "I have every intention to make sure that every single person has the fullest amount of benefits available and draw down as many federal dollars as we possibly can" ("KPCC News," KPCC, 12/10).
James Roache PharmD
With the state of the financial affairs in our near bankrupt state, why not simply follow the lead of several other states and let the feds set up the exchange? Our state has already received all of the grant money it can to complete the feasibility study, just conclude that, based on our financial condition, it would not be feasible for CA to develop its own insurance exchange and save the costs of the duplication of effort. I believe our state must begin to concentrate on how this care will be paid for once we reach the January 2017 date when CA will bear 100% of the cost of care. I understand that it is the role and desire of our folks in SAC to want to do their level best and keep their hands in this project, but realistically, we can't afford this extra expense.

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