It was a bit of good news earlier in the week when the Assembly Budget Subcommittee on Health and Human Services took a stand, and rejected the proposal for quarterly status reports in Medi-Cal for children and adults. With all the other items–even though it was clear the legislators were personally opposed, concerned, and questioning of some very tought cuts, say, of Medicare Part B premiums for vulnerable “dual-eligible” seniors and people with disabilities–the committee largely left the items open.
It’s standard for committee to leave the potential cuts on the table before May Revise, to keep options open until we know how much money comes in from the April 15 deadline. (Watch the money come in at Controller’s John Chiang’s website here.)
But they made a point by rejecting them outright, to indicate the severity of having hundreds of thousands of children and adults fall off the program. Now it’s our turn to convince people to reject a cuts only budget that includes QSRs, Medi-Cal rate increases, etc.
On this subject, The California Endowment recently put out a new report, “Stability and Churning in Medi-Cal and Healthy Families,” that indicates the insanity of QSRs. In looking at enrollment and retention patterns, the report finds:
- Overall, approximately 50% of newly-enrolled children “survive” after 21
months of enrollment in both Medi-Cal and Healthy Families;
- The sharpest drop in enrollment is seen at the 12-month renewal point, especially for children in Healthy Families and those in the 1931(B) and children’s percent programs in Medi-Cal;
- For children in other Medi-Cal – especially those who are also receiving food stamps or cash assistance — the drop is more gradual over time. These families need to renew more frequently to maintain the other social supports and thus, stay in closer touch with county assistance agencies.
- More frequent renewals will hit hardest children in the 1931(b) and percent programs of Medi-Cal. It is likely that half the children in these programs will be dropped at every renewal period.
- These families are teetering on the brink of poverty, are likely to be affected by an economic downturn, and may need the support health coverage offers for their children.
- Costs of medical care are substantially higher immediately after a gap. The longer the gap, the higher the cost afterwards.
- In Medi-Cal, it is likely that costs saved in the short-term by reducing enrollment using Quarterly Status Reports will be offset by pent up needs later on (or transferred to the safety net in the shorter term).