June 19, 2015

Medi-Cal faces growing risk from patient load

By the OC Register Editorial Board | Orange County Register

As enrollment soars, doctors are becoming scarce. That’s the dilemma faced by Medi-Cal, the state’s version of the national Medicaid program for the poor, in the two years since the federal Affordable Care Act has been implemented. The symptoms:

• A report by the Kaiser Family Foundation found enrollment in Medi-Cal has increased by 34 percent, or 3 million people. Total enrollment now is 12.4 million, a third of the state’s population.

• According to the Robert Graham Center, a health policy think tank, by 2030 California needs 32 percent more primary care doctors, an increase of 8,243.

• Medi-Cal enrollment is 17 percent of overall U.S. Medicaid enrollment, even though our state has just 12 percent of the U.S. population. The federal government currently pays 100 percent of Medi-Cal costs; but that will drop to 90 percent in just five years, with state taxpayers supposed to pick up the rest.

On June 16, state Auditor Elaine M. Howle released a report on the California Department of Health Care Services, which administers Medi-Cal. It found HCS “did not verify health plan data; therefore, it cannot ensure that the health plans had adequate provider networks to serve Medi-Cal beneficiaries.” It also criticized inadequate quarterly “assessments of provider networks.”

To treat these ailments, state Sen. Richard D. Roth, D-Riverside, has introduced Senate Bill 22 to create a public-private program to increase residency positions in teaching hospitals. The state would match private funds to create the positions – helpful, but, depending on the state’s fiscal health, the number of positions could be inconsistent.

SB22 has bipartisan support. And Sen. Roth’s office told us it’s on a two-year track, with major consideration in 2016.

We have preferred private solutions to health-care needs, including for the poor. Improving the state economy with lower taxes and regulations also would move more poor people into the middle class, with private instead of public health insurance. But the state has chosen government-run solutions and will have to live with the chronic fiscal migranes.


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