Inclusion Sparks Optimism, but Concerns Arise about Potential Risk to County Safety-Net Programs
OAKLAND, Calif. – California’s ethnic health leaders praised the state’s decision to expand the Medi-Cal program in the budget proposal released today, but expressed concerns about the potential impact on county safety-net programs. Under the Affordable Care Act (ACA), states can expand Medi-Cal to childless adults earning up to 138% of the Federal Poverty Level (FPL), which will be fully funded by the federal government from 2014-2016.
A new fact sheet, released by the California Pan-Ethnic Health Network (CPEHN), has found that over two-thirds (67%) of those newly eligible for coverage would be from communities of color and more than one-third (35%) will speak English less than very well. Without efforts to simplify enrollment and conduct culturally and linguistically appropriate outreach, 300,000 Californians, 70% of whom would be from communities of color, are expected not to enroll in Medi-Cal despite being eligible.
“We applaud the Governor for his commitment to expanding the Medi-Cal program,” said Ellen Wu, Executive Director of CPEHN. “This expansion will go a long way in helping communities of color get the care they need.”
The proposed budget includes $350 million in funds to pay for changes to California’s eligibility system, including establishing new standards for income eligibility and eliminating the asset test. “With such a large portion of the newly eligible speaking English less than very well, we are glad to see the state moving to simplify enrollment processes so everyone who is eligible for coverage will get enrolled,” said Kathy Ko Chin, President and CEO of the Asian & Pacific Islander American Health Forum. “It will be important for the state to provide culturally and linguistically appropriate outreach so that we can maximize enrollment by ensuring that all communities are aware of the available coverage options.”
The budget proposal includes two expansion options, 1) a state-based Medi-Cal expansion that would build upon the existing state-administered Medicaid program and 2) a new county-based system that would build upon the existing Low-Income Health Program (LIHP).
Under the centralized state-based approach, counties may see a significant reduction in state funding for safety-net programs including funding for indigent health services and state subsidized childcare. “The number of uninsured in California grew to 7 million last year,” said B. Darcel Lee, Executive Director of the California Black Health Network. “Thanks to the ACA, 1.4 million Californians will be newly eligible to access health coverage through Medi-Cal in 2014. While it’s good to see the Governor taking steps to fulfill the promise of health care reform, we urge him not to do so at the expense of the other vital county safety-net services on which our communities will still rely.”
“Latinos comprise close to half (48%) of those newly eligible for coverage under the expansion,” said Monica Blanco Etheridge, Executive Director of the Latino Coalition for a Healthy California. “However, our communities also represent over two-thirds (66%) of those who will still be uninsured and will still depend on counties for health care services. We’ve already seen huge disparities in the way counties provide these services for our communities. A county-based approach to the Medi-Cal expansion will undoubtedly lead to unequal access to care, posing significant challenges to our communities. It is therefore essential that California engages in a full expansion of Medi-Cal in order to draw down the enhanced federal match prescribed in the ACA.”
“Regardless of the approach the Medi-Cal expansion takes, our state has an obligation to conduct an honest assessment of what it will cost to continue to provide care to the remaining uninsured to make sure no harm comes to those communities,” said James Allen Crouch, President of CPEHN’s Board of Directors and Executive Director of the California Rural Indian Health Board. “Any funds redirected from counties to the state to pay for the expansion should be conducted through a transparent and open process with meaningful engagement by California’s diverse consumer stakeholders.”
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The Asian & Pacific Islander American Health Forum (APIAHF) influences policy, mobilizes communities, and strengthens programs and organizations to improve the health of Asian Americans, Native Hawaiians, and Pacific Islanders.
The California Black Health Network (CBHN) advocates for policies and programs that will improve the health status of people of African descent in California.
The California Pan-Ethnic Health Network (CPEHN) works to eliminate health disparities by advocating for public policies and sufficient resources to address the health needs of communities of color.
The California Rural Indian Health Board (CRIHB), Inc. is devoted to the needs and interests of the Indians of Rural California.
The Latino Coalition for a Healthy California (LCHC) is committed to initiating and advancing policies that will increase access to health services and build healthy Latino communities in California.