Capitol leaders offer legislation to expand Medi-Cal

Democratic leaders of the Assembly and the Senate have proposed legislation to carry out a federal mandate starting in 2014 to expand eligibility to 1.6 million Californians for Medi-Cal, the state’s health care system for the poor.


The action coincided with the beginning of a special legislative session called by Gov. Jerry Brown to focus on the complicated implementation of the Affordable Care Act, which expands coverage under Medi-Cal – California’s version of Medicaid — to everyone under age 65 with incomes that don’t exceed 133 percent of the federal poverty level.


An individual earning $14,856 annually is at 133 percent of the poverty level in the 48 contiguous states. Alaska and Hawaii are higher. A family of four would make $30,657 a year.


“Expanding health care coverage brings stability to California’s wider economy, especially young adults, the Latino community, and the self-employed,” said Senate President Pro Tempore Darrell Steinberg in a statement announcing introduction of his bill, SB 1x. “No illness should force financial devastation on individuals or their families.” The bill was introduced on Jan. 28.


The Sacramento Democrat’s measure is identical to AB 1x by Assembly Speaker John Perez, a Los Angeles Democrat.


Neither bill does more than what’s required under federal law.


Enacted in March 2010, the Patient Protection and Affordable Care Act represents the biggest change in the United States health care since 1965 when Medicare and Medicaid were created.


A key part of the legislation’s goal of sharply reducing the number of uninsured in California and the nation is placing more lower income persons under state and federal-paid medical care.


Just under 49 million Americans lack health coverage, the US Census Bureau said in 2011. That’s down 1.4 million from 2010.


California has the largest number of persons under age 65 without coverage in the nation — 7.1 million. One in four working Californians are uninsured, according to a December 2012 report by the California Healthcare Foundation.


About one in five Californians are served by Medi-Cal, an estimated 7 million. The program is expected to reach one in four  Californians after eligibility is broadened.


Doctors complain the reimbursement rates they’re paid to treat patients under the program are too low and caution there might not be enough doctors to handled the expanded pool of potential patients.


The legislation by Perez and Steinberg expands Medi-Cal eligibility to persons at or below 133 percent of the federal poverty level and attempts to streamline enrollment and renewal.


It also would implement a new way of determining the amount of income that counts toward eligibility.


The “Modified Adjusted Gross Income” methodology is basically the way the taxable income is calculated under Internal Revenue Service rules.

Former foster kids enrolled in Medi-Cal when they were 18 would continue to receive care until they are 26 under Perez and Steinberg’s bill – another requirement of the Affordable Care Act.


Two identical bills were introduced in each house to speed passage of the proposal, a Steinberg spokesman said.


The special session called by the Democratic governor runs concurrently with the Legislature’s regular session.

Ed’s Note: This story originally appeared in Greg Lucas’ blog, California’s Capitol.


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