HEALTH ACCESS UPDATE
Monday, January 26th, 2004
* MEDI-CAL REDESIGN PROCESS STARTS
* SB 2 ON NOVEMBER BALLOT, POLLS WELL
* CONFERENCE ON MANAGED CARE
ADMINISTRATION TO REDESIGN MEDI-CAL FROM A “BLANK SLATE”
Earlier today in Sacramento, HHS Secretary Kim Belshe led a presentation for
various “stakeholder” organizations regarding Governor Schwarzenegger’s
proposals for “Medi-Cal reform.” Over 100 representatives of provider,
consumer, and constituency organizations, as well as legislative offices,
listened and asked questions about the proposals.
Little new information was given on the substance of the Medi-Cal redesign,
which would include changes to eligibility rules, benefits, cost-sharing,
and the use of managed care.
SUPER-WAIVER: The goal of the Administration is to submit a statewide 1115
“super-waiver” to significantly redesign the Medi-Cal program “from the
ground up,” that would grant considerable “flexibility” to the
Administration, and possibly subsume all existing county and state waivers
into a comprehensive package.
TIMELINE: The Administration hopes to do all the work necessary to submit
this waiver by this October, and to quickly get approval by the federal
government by December 2004. This would allow the first half of 2005 for
county and system changes, and for a phased-in implementation to start July
To meet this ambitious timeline, the Health and Human Services Agency
started its “stakeholders meetings” in Sacramento, with another meeting to
be scheduled in the next few week in Los Angeles. They have created three
workgroups (and possibly might add others) that will meet monthly, on:
* benefits and beneficiary cost-sharing
* managed care
After these workgroups and larger stakeholder meetings in the next few
months, the Administration plans to submit a “waiver concept paper” to the
legislature in May, possibly tied to May Revise. They plan to get the
legislature to approve budget trailer bill language to implement a waiver in
June/July 2003, with the passage of the full budget. They have committed to
public hearings on the waiver before its final submission in October.
GOALS: While Belshe, Stan Rosenstein (Deputy Director of Medical Care
Services, Department of Health Services), and Tom McCaffery (Chief Deputy
Director, Department of Health Services) did indicate they would not do
“wholesale” eliminations in benefits or eligibility, they left a lot of
options on the table. And when asked, they were clear that they ultimate
goal was to acheive “cost containment,” and that $400 million was a “target”
for reduction in Medi-Cal funding as a result of these reforms. More
information is available at www.chhs.ca.gov.
Health advocates are working within these workgroups, and outside of them,
to prevent changes and cuts that deny children, families, seniors, and
people with disabilities needed care.
SB 2 PLACED ON NOVEMBER BALLOT BY APPEALS COURT; DOES WELL IN POLL
A referendum on SB 2 (Burton/Speier), the law to expand health coverage to
one million Californians and protect health coverage for millions more who
now get such benefits through their employer, was placed on the November
2004 ballot by an appeals court last week.
The appeals court overturned a lower court ruling in December, that
invalidated petitions to put a referendum on SB 2 on the ballot because they
were declared “misleading.” Since it was too late for the March 2004 ballot,
the appeals court reinstated the SB 2 referendum for November.
While business interests like Macy’s, McDonald’s, and Wal-Mart will wage an
expensive campaign against SB 2, a new poll indicates voters are inclined to
support the bill. The Field Poll indicated that “a large majority (65%)
supports the measures basic provisions after they are described. While
support for SB 2 is strongest among Democrats and women voters, pluralities
of voters across all major subgroups favor the new law.” Check out the poll
Advocates for the insured and the uninsured will begin meeting to strategize
about the campaign to lead up to the November vote.
MANAGED CARE CONFERENCE
ATTACHED is a flyer from the Western Center on Law and Poverty on their
conference, March 9-10, in Burbank, CA: “Making Managed Care Work: A Two Day
Conference for Consumers, Advocates, and Providers.”
Anthony E. Wright
1127 11th St., #234, Sacramento, CA 95814
Ph: 916-442-2308, Fx: 916-497-0921