CA: Governor's overhaul of Medi-Cal ready next week

SACRAMENTO (AP) - A much-anticipated plan to reform the state's mammoth public health program for the poor will be ready for review next week as part of Gov. Arnold Schwarzenegger's revised budget proposal, officials said Wednesday.

The Medi-Cal reform plan, which needs approval of both the federal government and the Legislature, is expected to call for higher co-payments and new limits on care for enrollees of the system. The governor also wants to impose new regulation on care for the blind and disabled and may also seek a cap on enrollment.

Medi-Cal reform comes forward as key lawmakers Wednesday also considered new legislation aimed at preventing fraud in the $30 billion public health program. Meanwhile, a state watchdog agency issued a report critical of the state's oversight of health and human service programs.

Legislators and health care advocates said they expected public health spending to emerge as one of the main points in this year's budget debate.

In an effort to remove opposition and speed approval of his budget plan, Schwarzenegger has already negotiated spending deals with several interest groups, including education and local government. But Democrats, who control both houses of the Legislature, remain skeptical of the governor's plan to trim billions of dollars from medical services for the needy. Some advocates are preparing for a fight.

"Health care is always the dividing line, but we expect it to be much more so this year," said Anthony Wright, executive director of Health Access, a group representing a coalition of labor and consumer organizations. "With education and local government, the administration has asked them to take their hit now and promised to make them whole in two years. With health care they are talking about permanent cuts."

Although the governor's office has not commented publicly on the plan, Wright said administration officials have told him the Medi-Cal reform plan will be released next week as part of the budget package. He said the governor wants to release a concept paper outlining the plan and potentially proposed legislation as well.

Aides to key legislators, speaking on condition of anonymity, said administration officials have told them the same thing but released no details.

Medi-Cal is the state's version of the federal Medicaid program that provides services to the elderly, disabled and children.

Noting that the state's share of Medi-Cal costs have risen more than $3 billion a year since 1998, Schwarzenegger said in January that reform of the system was a high priority.

Since then, the administration has met with health care providers and public health advocates about its reform plan. The administration wants to submit the plan to federal officials this year to get their approval without risking the $19 billion of federal money out of the overall $30 billion spent on Medi-Cal.

Robert Miller, a spokesman for the Department of Health Services, said Wednesday he could not comment on the reform package because it has not been completed.

While Schwarzenegger wants to save money by shifting costs to patients and limiting choices, that could cost the state more in the long run, some budget analysts said.

For example, the federal government has agreed to some Medicaid changes in other states in exchange for a cap on the amount of federal money for future services, said Jean Ross, director of the nonprofit California Budget Project. But that's risky, she said, because of the steadily escalating costs of medical care.

In a related development Wednesday, the Assembly Budget Committee considered legislation aimed at preventing more of the estimated $2 billion lost annually to Medi-Cal fraud. One bill, which could be introduced as soon as Monday, would attempt to prevent wealthy retirees from sheltering assets and income so that they can qualify for state aid.

Committee members also want the Department of Health Services to convene quarterly meetings with Medi-Cal managers to coordinate anti-fraud efforts.

The Little Hoover Commission, a bipartisan, independent panel that promotes efficiency in state government, also released a report Wednesday that criticized the state Health and Human Services Agency as being rife with duplication and failing to provide basic services.

The commission noted that five departments license or certify facilities and personnel; seven departments are involved with managing Medi-Cal programs; and there are more than 60 computer data systems that gather information that is rarely used or shared to improve services.

The agency called on the Legislature to move more of the responsibility and funding for public health and social services to local governments where they believe the services can be more efficiency delivered.

Not to worry. Following Secretary of Veteran Affairs Anthony J. Principi's example as he cut veterans benefits, California can tell its veterans that they "may have a false expectation of care". That is, California veterans who may be on Medi-Cal could be expunged to keep Medi-Cal available for "the elderly, disabled and children" among our two million to four million ILLEGAL aliens. There will be no discussion whatsoever of cutting non-citizens, legal or ILLEGAL, from Medi-Cal. Don't even think about it. Higher taxes for citizens and begging for federal money (money from other states) but NO cuts for legal and ILLEGAL aliens.

We're California, we're diverse. Uh.. U.S. dollars only please when you send your money to us via Washington.

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