Healthy Families Savings Goes from $13M to $137K

by David Gorn

TOPIC ALERT:

At a legislative hearing yesterday, state officials said the estimates for savings have been reduced for the Healthy Families transition to Medi-Cal managed care.

According to the Legislative Analyst's Office, the original estimated general fund savings for the Healthy Families transition was $13.1 million in 2012-13. The estimate has shrunk to $137,000. Savings for next fiscal year -- 2013-14 -- were estimated at $52 million and that estimate has been revised to $43 million.

Scott Ogus, who represented the Department of Finance at yesterday's hearing, said there were several factors contributing to the revision. Delays in implementation by the Department of Health Care Services led to caseload changes. DHCS officials have said the department slowed down some of the early phases of the transition so children would have less disruption in continuity of care.

"The main reason for the erosions is because of caseload changes," Ogus said. "Those eye-popping numbers from $13 million to $137,000 are due to some of these delays."

Sen. Bill Emmerson (R-Redlands) was not pleased with the fiscal projections, coming on the heels of some recent access issues.

"Last year I opposed eliminating Healthy Families," Emmerson said at yesterday's hearing, "and all information I've seen since then confirms that [was the proper stance]. The latest network assessment shows much more limited networks than the Healthy Families network did."

Emmerson said the Legislature voted for Healthy Families elimination based on the money that would be saved from it. Significant savings have not materialized, he said.

"We were told last year, shifting it would save $13 million, now we see we're paying an extra $10 million in administrative costs. So the savings is practically zero," Emmerson said. "You say we're going to save $42 million this year, and you can count me as a skeptic."

State officials also said yesterday savings estimates have also shown erosion for the duals demonstration project, now known as Cal MediConnect.

State officials said that's due, in part, to the smaller number of allowable participants in the eight-county demonstration project moving dual-eligibles (those eligible for Medicare and Medi-Cal coverage) into Medi-Cal managed care plans. Federal officials capped enrollment numbers in Los Angeles County and did not approve the state's request for a six-month lock-in for participants.

DHCS officials said they will submit an updated fiscal estimate for the duals project with the May budget revision.

George Lauer
Editor's note: This story has been changed to identify state Sen. Bill Emmerson as a Republican. An earlier version identified him as a Democrat.
Carol Frandsen
Just got the new health cards after my daughters Healthy Family transition. 13 years with the same PCP, 4 years with the spine specialist for curve, and dermatologist for severe acne-gone! All her records have to stay with them and we have to start over somewhere else. We were assured that we could keep our drs. and continuation of care would be stable. NO. Now I have to file grievances, and COCs. I am so disgusted and feel for every parent/child who got "thrown under the bus" I urge everyone to call Brown and Steinberg( if he's not too busy trying to save a basketball team) and tell them your story. I am sure the parents of HF would have had no problem paying slightly more in premiums/co-pays. That was never on the table. Many HF members were self-employed/small business owners and now the ACA is being delayed fot that group until 2015. I have no faith that this country is ever going to deal with healthcare on any intelligent or compassionate level-NONE
Patrick Hagan
900,000 Healthy Families children were pawns in this move. The state didn't save the $13 million and Maximus was allowed to keep over $216 million for years 2014, 2015, and 2016 even though the Healthy Families program was terminated.

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