Health and Human Services 01/11/2013
Medicaid Expansion Achievable With Minimal Costs, Says Report
A new report indicates that a Medicaid expansion in California
under the Affordable Care Act is achievable with minimal state
costs.
The report, released this month by the University of California
Berkeley Center for Labor Research and Education and the UC Los
Angeles Center for Health Policy Research, estimates that the
federal government will pay for at least 85 percent of new
Medi-Cal spending in 2014 through 2019 if the expansion takes
place.
Titled “Medi-Cal Expansion Under the Affordable Care Act:
Significant Increase in Coverage with Minimal Cost to the State,”
the report estimates more than 1.4 million people will be
eligible for Medi-Cal services under the expansion, and that some
administrative costs and rule changes associated with the ACA are
unavoidable. However, the report argues that the expansion will
benefit not only the health of the newly eligible population, but
also the state budget and the California economy as a
whole.
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Phase 1 of Healthy Families Program Shift to Medi-Cal Underway
The state received approval from the federal government at almost
the last minute – at 6 p.m. on December 31, 2012 – to begin the
shift of Healthy Families Program children to the state’s
Medi-Cal program.
Phase I, part A, of the shift is now underway, which includes
about 200,000 children in HFP plans that are also Medi-Cal
Managed Care plans. This means that they will not have to change
health plans. Part A includes children in Alameda, Orange,
Riverside, San Bernardino, San Diego, San Francisco, San Mateo,
and Santa Clara Counties. Part B will begin in March for children
in Contra Costa, Fresno, Kern, Kings, Los Angeles, Madera,
Monterey, Napa, Sacramento, San Diego, San Luis Obispo, Santa
Barbara, Santa Cruz, Solano, Sonoma, Tulare, and Yolo
Counties.
Phase 2 will begin in April and will include children whose HPF
plan subcontracts with a Medi-Cal Managed Care plan. This means
that they will not have to change health plans.
Phase 3 will begin in August and will shift children whose HFP
plan is not part of a Medi-Cal Managed Care plan. They will be
able to move into a Medi-Cal managed care health plan of their
choice, but must make that choice prior to August 1, 2013. If a
choice is not made, children will be automatically enrolled into
a plan using a formula that tries to match them with their
current provider, if there is provider linkage with a Medi-Cal
manage care health plan.
Phase 4 would begin in September and would take place in the
counties where there is currently no Medi-Cal managed care health
plan. Children would have the option to move into Fee-for-Service
Medi-Cal, or into new managed care plans if the planned rural
expansion of managed care has taken place by then.
CSAC, along with county affiliates and other stakeholders,
continues to monitor this issue, especially as it relates to the
county role in eligibility and technology issues.