Health reform has expanded Medicaid access to millions of Americans. The question is, will the poor even want Medicaid insurance? As finances are tightening, many states are attempting to reduce the generosity of their current Medicaid benefits.
In California, (where Medicaid is known as Medi-Cal), Governor Jerry Brown wants to reduce Medicaid’s benefit generosity. He proposes the following:
Brown wants to scale back some of the benefits the Legislature has proposed. Long-term care for the disabled would not be part of the package under the governor’s plan. Also under Brown’s plan, groups that are now covered by Medi-Cal, including certain AIDS and cancer patients and recent legal immigrants, would be shifted into a state-run insurance exchange where they would receive partial coverage but pay premiums for the first time…Brown also wants to reduce the roughly $2 billion the state gives to counties each year to care for the uninsured — whose numbers will fall — to offset new administrative costs.
On the other hand, California’s Democratic legislatures want these benefits to remain in the Medi-Cal package.
Although the federal government picks up most of the cost of the Medicaid expansion in the early years of the implementation, States will bear the brunt of the financial burden after that.
In addition to cuts to benefits, Medi-Cal reimbursement rates are also far from generous. “Assemblyman Wesley Chesbro (D-Arcata) noted that the state has repeatedly cut Medi-Cal reimbursement rates, shrinking the pool of healthcare providers who participate in the program. And now demand is expected to swell dramatically.”