Medi-Cal faces major funding cuts

Doctors and nurses guide a young patient on a gurney down a hospital corridor. (Photo: Spotmatik LTD, via Shutterstock)

Billions of dollars for California’s health care system serving 13 million poor and young people would be slashed under a proposal in Congress backed by House Majority Leader Kevin McCarthy and other top Republicans.

The plan, called the Affordable Health Care Act, is expected to come up for a House vote on Thursday. It contains the biggest potential change to California’s system since its inception more than 50 years ago.

Of the $6 billion in 2o20, the state’s General Fund — it’s main pocket of sales, income, insurance and corporation taxes — would be on the hook for about $4.3 billion.

The proposal would cut money and then force states to make up the difference — in California’s case, nearly $6 billion in three years and $24.3 billion in 2027, according to an analysis by Jennifer Kent. Kent is the director of the state’s Health Care Services Department, which supervises California’s Medi-Cal program.

Medi-Cal, which was expanded sharply under Obamacare, is California’s version of Medicaid, the federal health care program.

Of the $6 billion in 2o20, the state’s General Fund — it’s main pocket of sales, income, insurance and corporation taxes — would be on the hook for about $4.3 billion, and $18.6 billion in 2027, according to Kent.

Gov. Jerry Brown told McCarthy that the GOP plan would eliminate health care services for millions of people, and “going back to a system where the only available care is in an emergency room is not smart.”

“The uninsured  rate in California  has gone down from  17.2 percent  in 2013 to a historic low  of 7.4 percent in 2016,” Brown wrote, adding that medical insurance premiums rose in California by about 4.5 percent over the same period, nearly half the rate nationally, 8.8 percent.

Currently, Medi-Cal is funded by a roughly even mix of state and federal money.  Under Obamacare, its client load was expanded to about 13 million people, or about one in three Californians. Medi-Cal provides free or low-cost medical care to low-income people and families who meet income requirements.

The new proposal would cut back on funds to the state, which would have to find a way to make up the difference. It also proposes that adults on Medi-Cal be required to reapply for eligibility every six months, an administrative rule that likely would cause turmoil among those enrolled in the program.

It would halt federal payments to programs that offer abortion services, such as Planned Parenthood. In California, Planned Parenthood and related programs provfide services to about 600,000 people annually, and receives about $400 million in federal funding. The proposal also could result in major costs to hospitals. According to Kent, about 25,000 individuals each month are covered through hospitals that receive funding under the existing program.


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