Advocates Push for Expansion Compromise

by David Gorn


The Legislature last week moved two key components of the special session bills on health care reform. SBX1-2 by Sen. Ed Hernandez (D-West Covina) and ABX1-2 by Assembly member Richard Pan (D-Sacramento) passed through committees of the opposite house. Bothbills make changes to the individual health insurance market.

The Assembly Committee on Health approved SBX1-2, and it's now going to Appropriations; and ABX1-2 moved through the Senate Committee on Health on its way to Senate Appropriations. Both bills were approved in floor votes in their own house so they are nearing final approval.

Also last week, a Senate floor vote unanimously approved SBX1-3 by Sen. Hernandez, the bridge plan to help people move from Medi-Cal to the exchange more easily. That bill now moves to the Assembly.

Those are significant steps toward final approval, but they belie underlying controversy around the third component of health care reform in the special session.

The bills to implement optional Medi-Cal expansion  -- ABX1-1 by Assembly member John Pérez (D-Los Angeles) and SBX1-1 by Hernandez -- are stuck in committee while legislators hash out possible changes with the Brown Administration.

At issue is the money counties are expected to save with the expansion of roughly one million Californians with inclome up to 138% of federal poverty level into Medi-Cal. Federal money will pay for 100% of that expansion the first three years, declining to 90% by 2020.

That should be a boon to counties. State officials contend the state should share in that cost savings. How that money should be divided has become a long discussion in Sacramento. Wendy Lazarus, co-president of The Children’s Partnership, said it needs to be resolved soon.

"Any further delay in hammering out the terms of the Medi-Cal expansion will have negative impacts on low-income kids and families," Lazarus said.

The reason these bills were put in special session is because they're time-sensitive, Lazarus said, adding  that taking the issue beyond the May revise endangers smooth implementation of them.

"Once the financing terms are agreed on, it will take time to get the enabling legislation right," she said. "Then more time is needed to set up the machinery for enrollment under the Medi-Cal expansion and the mechanics of the relationship between the state and counties."

The bills have passed their house of origin. Currently, ABX1-1 is in the Senate Committee on Health; SBX1-1 is in the Assembly but has not yet been assigned to committee.

Lesha Holland
What never seems to be mentioned in most discussions of Medi-Cal expansion plans is that being low-income is not enough to determine eligibility. For as long as I can remember, one must either have minor children or have a medical disability of some sort. Would any expansion of coverage under the ACA take this into account? I'm never quite sure if some of the bureaucratic obstacles I have encountered are due to the county in which I live (San Diego) or apply to the entire state. I know that the elimination of adult dental, eyeglasses and hearing aids was statewide, but: As a recipient of a small SSI check each month [as opposed to Social Security Disability or a regular paycheck] I am told I am not eligible for any assistance under the SNAP ["Food Stamps"] Program. Even though my SSI is less than $300, and the grand, combined total of all sources of income I receive each month is less than $900. If my income were this low [or even hundreds $ HIGHER]from WORKING, I'd qualify. SO o

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