Monday, August 2nd, 2004


* Administration Still Moves Forward, But Different Timetable

* California Performance Review, Unveiled Tomorrow, to Include Some Proposals on Medi-Cal

Today, Secretary of Health and Human Services Kim Belshe announced that the Schwarzenegger Administration will NOT be releasing its controversial proposal to restructure the Medi-Cal program, which provides health coverage to more than 6.7 million low-income children and their parents, seniors, and people with disabilities.

“A few key issues still need to be resolved,” read a statement. Yet it continued: “The Administration remains firmly committed to restructuring Medi-Cal, and the Governor plans to present a restructuring proposal as part of the January budget.” The statement is available at the Medi-Cal redesign web site, at:

While not explicitly stated, it is understood by several advocates that the Administration is NOT planning on seeking a Medi-Cal redesign waiver from the federal government this fall, as had been suggested in previous documents. The Administration will be seeking a renegotiation of a SPCP (Selective Provider Contracting Program) waiver, which expires at the end of the year, and is critical for the funding of California’s public and other safety-net hospitals.

The statement indicated that the Administration will work until January to refine policy components of the proposal, to work “with federal officials and safety net hospitals to resolve outstanding issues on hospital financing,” and to “review and analyze Medi-Cal program improvement ideas coming out of the California Performance Review for possible inclusion in the restructuring proposal.”

In fact, the California Performance Review report, to be released tomorrow, Tuesday, August 3rd, is expected to include a number of proposed changes in Medi-Cal, including: consolidating eligbility processing and reporting requirements for Medi-Cal, CalWORKs, and food stamps. realigning state and county responsibility for health care of indigent care and children’s services; contracting to boost enrollment of eligible Medi-Cal patients into Medicare; adopting a self-certification process for the asset test for children and families; identifying and disenrolling Medi-Cal patients who have other health coverage, and other proposals. Health Access will put forward a more complete analysis after the report is released.

The delay in the unveiling of Medi-Cal redesign is a victory, however temporary, for health advocates concerned about the various proposals that would have made millions of Californians pay more for care, or experienced greater barriers for getting the care they need. Advocates were successful in raising hard questions about the proposals. It was also hard to imagine the Legislature adopting such an ambitious proposal in such a short timeframe, of less than a month. While the Schwarzenegger Administration is clearly committed to the proposals as has been outlined to date, the delay until January could impact the politics around the proposal, especially if California is negotiating with a federal Administration under a new President.

Health Access California promotes quality, affordable health care for all Californians.
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