Gov. Brown and Democratic lawmakers finally came to terms today, but it's not pretty. In addition to deep cuts in California's welfare program, next year's budget would shift 880,000 children from the Healthy Families program to the lower-cost Medi-Cal system. Healthy Families supporters were outraged by the switch; they're worried that many kids might fall through the cracks. From California Health Report:
Medi-Cal and Healthy Families are both joint state and federal programs offered to low-income families, but they serve different populations in different ways. Medi-Cal serves adults and children from families at or below the poverty level. Some of those children get their care through managed care plans and others see doctors or go to hospitals that are reimbursed from a fee schedule set by the state. Families are not required to pay any premiums for their coverage. Healthy Families is aimed at children up to 19 years old in families that don't qualify for Medi-Cal and have incomes up to 250 percent of the poverty level, or about $46,000 for a family of three. Families are given private insurance and pay premiums on a sliding scale, according to their income. For Medi-Cal, the federal government matches California's spending with roughly a dollar for every dollar the state spends. For Healthy Families, the federal government provides $2 for each dollar the state spends.
The most obvious potential problem: Not enough doctors will want to participate in the Medi-Cal program because the fee structure is too low. Here's a rundown from the Sacramento Bee:
What it does: Provides subsidized medical coverage for 880,000 children whose parents earn more than the federal poverty level but lack health insurance. Families can qualify if they earn below 250 percent of federal poverty level, roughly equal to $56,325 for a family of four.
Democratic budget: Shifted 187,000 children whose parents are at 133 percent of federal poverty, or $29,725 for a family of four, to Medi-Cal. Those children are already slated to go to Medi-Cal in 2014 under the federal health care overhaul whose fate is in the hands of the U.S. Supreme Court.
Compromise budget: Shifts all 880,000 children to Medi-Cal in three phases during 2013. The first group involves 415,000 children on Jan. 1, 2013, who are currently enrolled in Healthy Family plans that also serve Medi-Cal.
Savings: $13.1 million in 2012-13, higher amounts thereafter