Compromise Proposed for Medi-Cal Expansion

by David Gorn

TOPIC ALERT:

A new plan is expected to be unveiled today offering a compromise approach to the state's optional Medi-Cal expansion.

Health Access California, a not-for-profit health advocacy organization came up with the plan as a bridge between the state's rough outline in the budget for two choices -- a state-administered or county-administered approach.

More than one million Californians will be newly eligible for Medi-Cal under the optional expansion to those people making up to 138% of federal poverty level. The federal government will pay 100% of expansion costs for the first three years, and 90% thereafter.

California's 58 counties stand to benefit from the expansion. It would be a significant boon to counties -- an expected $1.4 billion in savings -- to get so many uninsured Californians signed up for Medi-Cal.

The state wants a piece of that and has been working with counties over the past three months to hammer out some kind of agreement using either the state- or county-centered model as a starting point.

But according to Anthony Wright, executive director of Health Access California, the best option lies somewhere in the middle.

"We think the expansion is very important, and resolving this is important to break up the logjam," Wright said. "The proposal we're advancing addresses the remaining uninsured without having some assessment to deal with that responsibility."

Wright wants to keep the Low Income Health Program intact to handle the residually uninsured population. LIPH is due to expire at the end of the year.

"This is a good balance for the state and the county positions," Wright said.

That did not sound promising to Toby Douglas, director of the Department of Health Care Services, who spoke at an Assembly budget subcommittee hearing Monday.

"We are proposing to move forward on optional expansion on one of two formats," Douglas said. "At this point we have two alternatives. The options include a state-administered and county-administered approach. We have two options, not another option."

"It is long past when the decision should've have been made," said Jerry Jeffe of the California Chronic Care Coalition. "You can't wait for a May revise, you can't wait for a June budget, you have to move now and not delay delay delay."


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