Tuesday, January 11, 2005

State Medicaid Watch: California

This LA Times article on the Governor's proposed social services cuts contains some disability-related content:

Schwarzenegger also proposed abolishing the annual cost-of-living increases built into many healthcare and social services programs — something he has blamed for California's troubled financial state.

In addition to eliminating the cost-of-living increase for welfare benefits, he proposed scrapping a 4.5% increase in Supplemental Security Income for the elderly and disabled.

His budget would siphon away the $84.7 million Washington is providing to cover increases in the disabled program, and use the money to plug California's budget gap.

The budget unveiled a number of ideas to curtail the cost of the state's Medicaid program, Medi-Cal, which accounts for nearly a third of state spending, with $33.8 billion allotted for the fiscal year beginning in July. About 6.6 million people participate in the program.

The governor's proposal would impose a $1,000 annual cap on dental services for adults, excluding some federally mandated emergency services.

Under the plan, the elderly and poor receiving healthcare through Medi-Cal — except those in the most dire financial circumstances — would have to pay premiums up to $27 a month, depending on the number of children in the family.

The premiums would apply to elderly couples with incomes over $1,437 a month; single elderly with incomes above $812, and families above the poverty level.

The bulk of savings to Medi-Cal, however, would come by expanding the use of managed care — which now is used for half of the state's participants — to include 13 additional counties as well as all of California's aged, blind and disabled Medi-Cal patients. The administration projected that switching to managed care would save $136.6 million after the change took full effect, in 2007.

Robert Hertzka, president of the California Medical Assn., said managed care for the disabled, "we believe, would be disruptive of preexisting doctor-patient relationship," but that "on the whole, we're pleased that the governor has largely spared the state's health programs, with some exceptions."

As he did last year, the governor proposed that the state help pay only the $6.75 an hour minimum wage for in-home healthcare workers, instead of the $10.10 an hour the state now shares in paying.


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