California health officials need to go a little slower in their plan to move 875,000 children out of the Healthy Families program and into Medi-Cal managed care, according to a Senate budget subcommittee that voted yesterday to reject the state's full plan.
It did endorse the transition of about 200,000 Healthy Families "bright line" children to Medi-Cal -- those beneficiaries at or below 133% of federal poverty level. The Affordable Care Act requires that those children be moved to Medi-Cal by 2014, so California would get a head start on that effort, according to John Bacigalupi from the state Department of Finance.
"We support this because it would create efficiency by consolidating health care for the state's children under a single program," Bacigalupi said.
Children's health advocates were generally supportive of the state effort, but concerned about the possible loss of access to providers by moving almost a million kids into Medi-Cal managed care.
"We support the staff recommendation on this proposal, which is to reject it," said Carolyn Ginno, the associate director of the Center for Government Relations at the California Medical Association. "We are supportive of the compromise, to transition those children up until the bright line. We think that gives the state a good test population."
California should learn from its recent transition of seniors and persons with disabilities into managed care, Ginno said.
"We're all aware of recent experience here in California in transitioning public programs for health care service programs for the poor, and unfortunately that record is not so good," she said. " We think those 200,000 or so kids would give us a good opportunity to see how it works moving forward. But to move the whole proposal right now is premature, and will only serve to hurt people."
Helen Roth Dowden, a representative of Service Employees International Union, said the Healthy Families program has been a success in several ways.
"When you take a look at Healthy Families, [it's] where 80% of the kids are enrolled and they pay premiums every single month," Dowden said. "We think that looks a lot more like what the health benefit exchange is trying to accomplish."
The Senate budget subcommittee voted 2-1 to reject the full implementation.