SAN FRANCISCO — Supporters of health care reform once again sounded the alarm that California has only four to six weeks left to resolve budget issues that are hampering the timely rollout of Medi-Cal expansion, a key part of Obamacare’s implementation in the state.
Alameda County Supervisor Wilma Chan noted “the federal government will [fully] cover the first three years of Medi-Cal expansion to cover the uninsured.” She warned “the state could lose a lot of that funding if the expansion is not started on time, by January 1, 2014.”
“The Feds will start funding Medi-Cal [California’s Medicaid program] expansion on that day, but if we’re not ready at that time, every day that the expansion isn’t ready, is another day of funding gone. It will be a waste,” warned Anthony Wright, executive director of Health Access, a statewide health policy advocacy group.
Wright and Chan, as well as Mike Odeh of Children Now, were panelists at a Friday media briefing at the offices of New America Media on how a delay in expanding Medi-Cal could impact communities of color.
The Medi-Cal expansion would enroll an estimated 1.4 million uninsured Californians into the Affordable Care Act (ACA) coverage. But setting up the infrastructure for this is being hampered by disagreements between Governor Jerry Brown and state legislators.
For example, Brown rejects the use of self-enrollment electronic stations, which advocates argue would simplify and quicken the enrollment of hundreds of thousands. He also wants to be able to turn off Medi-Cal expansion coverage should there be reductions in federal funding.
Under ACA, the federal government has promised to cover 100 percent of expansion costs in the first three years, and at least 90 percent thereafter.
The governor also wants counties to operate the expansion program, a suggestion that is unpopular with county officials, who believe that it should continue to be a state-operated program.
Mike Odeh of the non-profit, Children Now, said up to 700,000 children need to be enrolled in expanded Medi-Cal but could be jeopardized if “enrollment categories are not simplified.”
The biggest budget debate, according to Wright, Chan, and Odeh, is that the Brown administration wants counties to turn over monies that now fund counties’ Low-Income Health Programs (LIHPs), which serve as a safety net for the uninsured, once expanded Medi-Cal begins functioning.
Advocates want those funds retained at the county level to cover the remaining uninsured—undocumented immigrants, legal immigrants who have been here for fewer than five years and can’t afford to buy insurance from the exchange, and people “who fall through the cracks”—not only to make sure that health care safety nets remain, but also to prevent the uninsured from resorting to costly emergency care.
“Open enrollment for Medi-Cal starts in October,” said Chan, “but these unresolved issues are delaying the preparations needed to inform, educate and enroll hundreds of thousands before the program kicks in by January 1.”