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

2005.

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:

* eligibility

* 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

at www.fieldpoll.com.

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

Executive Director

Health Access

1127 11th St., #234, Sacramento, CA 95814

Ph: 916-442-2308, Fx: 916-497-0921

awright@health-access.org