More on the R Budget on Health…

Medi-Cal Cuts


* Reduce Benefits to the Federal Minimum – Psychology -$95 (Gov) It would eliminate an optional benefit.

* Reduce Benefits to the Federal Minimum -Chiropractors -$196 (Gov) It would eliminate an optional benefit.
* Allow HIV/AIDS Pharmacy Pilot program to sunset. -$1,039 (LAO) The HIV/AIDS Pilot program was designed to test the effectiveness on patient outcomes of having pharmacists coordinate and monitor HIV/AIDS patients’ therapeutic drug regimens. The LAO notes that
providing direct services is a higher priority than the services covered
* Reduce Benefits to the Federal Minimum – Acupuncture -$1,400 (Gov) It would eliminate an optional benefit.
* Delay implementation of Discount Prescription Drug Program -$5,870 (SRFO) New program authorized by AB 2911 (Nunez, 2006) but delayed until 2008-09. AB 2911 received no Republican votes because it imposes de-facto price controls on prescription drugs sold to low-income Californians without drug coverage. As part of last year’s budget agreement, the Governor agreed to delay implementation of the program by one year.
* Reinstate Quarterly Status Reports for parents -$3,798 (Gov) It would require adult beneficiaries to provide eligibility information to the counties quarterly rather than every 6 months.
* Reduce Funding provided to Support Staffing for Caseload Growth Workload -$20,635 (Gov) Reduces funding to counties.
* Stop Paying Part B Premiums for Unmet Share-of-Cost Beneficiaries -$5,367 (Gov) It would eliminate state payment of Medicare Part B premiums for those individuals who have not met their share-of-cost requirements.
* Restore Quarterly Status Reports -$13,900 (Gov) Requires children to provide eligibility information to the counties quarterly rather than annually and would allow Medi-Cal to discontinue benefits for children no longer eligible for the program.
* Reduce Level of Services for Illegal Immigrants and Legal Immigrants Residing in
the Country for Less than 5 Years -$86,687 (Gov MR) It would reduce the level of benefits provided to new qualified immigrants (legal immigrants who have been in the country for less
than five years) and Permanent Residence Under Color of Law immigrants (illegal immigrants whom the US Citizenship and Immigration Services are aware of but are not actively pursuing
deportation of). Currently, both immigrant groups receive full-scope Medi-Cal, and this proposal would reduce benefits to the same level provided to undocumented immigrants, which includes emergency services, pregnancy-related services, long-term care, and breast and cervical cancer treatment.

* Rollback Recent Eligibility Expansions -$31,200 (Gov MR) It would reduce the allowable income level for 1931(b) applicants from 100% of the federal poverty level (FPL) to the CalWORKS level, which is approximately 68% FPL, and reinstate the 100 hour work rule without regard to income. Both the income expansion and the elimination of the 100 hour rule were implemented in 2000. The 1931(b) program provides Medi-Cal coverage to families with children that do not receive CalWORKS. This proposal is expected to reduce caseload by 39,000 adults in 2008-09; children will not be impacted. These changes will only apply to new applicants, and full-year savings of $342 million will not be achieved until 2011-12.
* Ensure Illegal Immigrants Do Not Receive Statutorily Prohibited Services -$42,000 (Gov MR) It would limit eligibility for illegal immigrants to the month in which emergency services are needed rather than providing illegal immigrants with annual eligibility. This will better ensure that illegal immigrants do not get services they are not entitled to. LAO considers unachievable.
* Extend 10% Provider Rate Reduction to Family Planning Providers -$5,476 (Gov MR) Would reduce Family Planning provider rates by 10%, in accordance with the 10% provider rate reduction approved as part of Special Session. These providers were exempt from the cut because they receive a higher federal match (90/10). However, there is no programmatic reason to exempt these providers, and not others, from the reduction.
* Reduce California Childrens Services Case Management by 10% -$2,683 (Gov) Reduces funding to counties.
* Reduce Benefits to the Federal Minimum – Creams and Washes -$2,947 (Gov) It would eliminate an optional benefit.
* Reduce Benefits to the Federal Minimum -Audiology -$1,729 (Gov) It would eliminate an optional benefit.
* Reduce Benefits to the Federal Minimum – Optometrists -$509 (Gov) It would eliminate an optional benefit.
* Reduce Benefits to the Federal Minimum – Speech Therapy -$110 (Gov) It would eliminate an optional benefit.
* Reduce Benefits to the Federal Minimum – Podiatry -$855 (Gov) It would eliminate an optional benefit.
* Reduce Benefits to the Federal Minimum – Opticians/ Optical Labs -$3,799 (Gov) It would eliminate an optional benefit.
* Reduce Staffing for Dental IT System -$700 (Gov) Governor’s Proposal; related to elimination of Adult Dental.
* Reduce funding for county administration of federal Deficit Reduction Act requirements. -$6,000 (LAO) The LAO believes counties will be able to fully implement DRA with $6
million less than originally anticipated.
* Delay 90% rate increase for FPACT -$30,258 (SRFO) Rate increases went into effect Jan. 1, 2008 due to SB 94 (Kuehl, 2007). Effectively increases family planning provider rates by 90%.

MRMIB


* Increase Co-payments for Health Services -$1,900 (Gov) Co-pays for families with incomes over 150% would increase from $5 to $7.50.
* Annual Benefit Limit for Dental Coverage – $1,000-$1,300 (Gov) It would set annual benefit level of $1,000. Approximately only 5% of users will be impacted.
* Healthy Families Program Premiums -$3,915 (Gov) Premiums would increase between $4 to $7 for the first time since 1998. Premiums would make up no more than 1.25% of a families
income.
* Certified application assistance payments -$4,700 (LAO) It would reduce payments to organizations that assist persons with

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