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Life Health > Long-Term Care Planning

Medi-Cal: A Post-Budget Review

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Broad budget cuts approved last month in California’s state legislature will impact many programs across the state — probably none so much as the health and human services arena, which saw significant drops in funding for Medi-Cal and services for the disabled. These cuts came as part of an $11 billion deficit reduction, making up for nearly half of the ground lost by the state’s total $26.6 billion budget shortfall.

In light of these changes, consumers will have questions about how their insurance coverage will change, what services will no longer be available to them, and how they can get the coverage they need at a price they can afford. Read on to learn just what changes will be enacted over the next few months.

The new Medi-Cal
As larger federal Medicare cuts loom, California predictably slashed its state program, saving $1.3 billion over the next year. Both consumers and physicians will share an increased burden to make up for the lost money: long-term care facilities and physician offices will be reimbursed 10 percent less than they currently are, while co-pays will rise for hospital visits, physician and clinic visits and services provided through the Healthy Families program.

Tom Gehring, chief executive of the San Diego County Medical Society, says he is concerned about how these cuts will impact physicians, and how this may in turn lead to lack of adequate care for patients.

“The [effect of these budget cuts] will be to further reduce an already limited number of physicians and systems who see Medi-Cal patients … and the paradox is that while Medicare spending levels are considered unsustainable, it’s physicians who have shouldered the lion’s share of cost reductions over the past 10 years.”

Program cut

Money saved

Medi-Cal co-pay for hospital admissions of $200 and co-pay for each day in the hospital of $100

$151.2 million

A 10 percent reduction in what the state pays for Medi-Cal patients at all long-term care facilities

$172.3 million

A 10 percent reduction in what the state pays to physicians who see people on Medi-Cal

$567 million

A cap on Medi-Cal visits to doctors of seven per year, unless otherwise medically necessary

$44.9 million

Medi-Cal co-payments of $3 (generic) and $5 (brand name) for prescription medications

$140.3 million

An increase in premiums and co-pays, benefits, and elimination of vision care for the Healthy Families program

$30.5 million

New Medi-Cal co-pay for physician and clinic visits of $5 per visit

$152.8 million

Other changes in health care
Cuts to other health care programs were just as sweeping, with large decreases in money made available to the developmentally disabled, and to in-home care and rehabilitation programs for the elderly. Children’s health care will face extreme cuts, too, with $1 billion being shifted from the early childhood development fund to a general fund for Medi-Cal expenses.

Program cut

Money saved

A broad cut to services for the developmentally disabled, including to regional centers

$568.6 million

Reductions to the In-Home Supportive Services, a program that’s an alternative to nursing home care.

$486 million

Eliminate Adult Day Health Care programs, which provide rehabilitation and social activities for elderly, disabled people.

$90 million

General reduction for the medical supply stockpile and mobile field hospitals for major public health emergencies

$5.8 million

Shift from early childhood development fund to the general fund for Medi-Cal expenses

$1 billion


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