Medicaid Expansion Achievable With Minimal Costs, Says Report

A new report indicates that a Medicaid expansion in California under the Affordable Care Act is achievable with minimal state costs. 

The report, released this month by the University of California Berkeley Center for Labor Research and Education and the UC Los Angeles Center for Health Policy Research, estimates that the federal government will pay for at least 85 percent of new Medi-Cal spending in 2014 through 2019 if the expansion takes place. 

Titled “Medi-Cal Expansion Under the Affordable Care Act: Significant Increase in Coverage with Minimal Cost to the State,” the report estimates more than 1.4 million people will be eligible for Medi-Cal services under the expansion, and that some administrative costs and rule changes associated with the ACA are unavoidable. However, the report argues that the expansion will benefit not only the health of the newly eligible population, but also the state budget and the California economy as a whole. 

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Phase 1 of Healthy Families Program Shift to Medi-Cal Underway 

The state received approval from the federal government at almost the last minute – at 6 p.m. on December 31, 2012 – to begin the shift of Healthy Families Program children to the state’s Medi-Cal program. 

Phase I, part A, of the shift is now underway, which includes about 200,000 children in HFP plans that are also Medi-Cal Managed Care plans. This means that they will not have to change health plans. Part A includes children in Alameda, Orange, Riverside, San Bernardino, San Diego, San Francisco, San Mateo, and Santa Clara Counties. Part B will begin in March for children in Contra Costa, Fresno, Kern, Kings, Los Angeles, Madera, Monterey, Napa, Sacramento, San Diego, San Luis Obispo, Santa Barbara, Santa Cruz, Solano, Sonoma, Tulare, and Yolo Counties.

Phase 2 will begin in April and will include children whose HPF plan subcontracts with a Medi-Cal Managed Care plan. This means that they will not have to change health plans. 

Phase 3 will begin in August and will shift children whose HFP plan is not part of a Medi-Cal Managed Care plan. They will be able to move into a Medi-Cal managed care health plan of their choice, but must make that choice prior to August 1, 2013. If a choice is not made, children will be automatically enrolled into a plan using a formula that tries to match them with their current provider, if there is provider linkage with a Medi-Cal manage care health plan. 

Phase 4 would begin in September and would take place in the counties where there is currently no Medi-Cal managed care health plan. Children would have the option to move into Fee-for-Service Medi-Cal, or into new managed care plans if the planned rural expansion of managed care has taken place by then. 

CSAC, along with county affiliates and other stakeholders, continues to monitor this issue, especially as it relates to the county role in eligibility and technology issues.