OVERVIEW

CPCA strongly supports the full expansion of Medi-Cal in order to benefit low-income Californians by saving lives and stimulating the economy. California is home to approximately 7 million people without health insurance. Californians living in poverty are significantly more likely to be uninsured than their higher-income counterparts, due to the high costs of health care and the lack of affordable options available to them.  The uninsured are more likely to go without regular, needed care, are more likely to be saddled with medical debt, and have decreased life expectancies.

But the possibility to significantly reduce the number of uninsured, low-income adults is within California’s grasp. The Supreme Court ruled in June that the Affordable Care Act permits, rather than requires, states to expand their Medicaid programs (Medi-Cal in California) to adults ages 18 to 64 with incomes up to 138 % of the Federal Poverty Level($15,415 annually for an individual).

Before now, adults were only eligible for Medicaid if they were a parent, senior or had a disability, but now states can cover these “childless adults.”  If California expands its Medi-Cal program, the federal government will pay all of the cost for the first three years, and will continue to cover at least 90 percent thereafter. CPCA strongly supports California’s Medi-Cal expansion and encourages all members to let your state legislators know how important Medi-Cal is to your community!  To visit the CPCA Health Care Ambassador page and learn more about making your voice heard, click here.

Medi-Cal Expansion Fast Facts

  • Affordable health care will be expanded for people living below 138% of the federal poverty level ($1,285/month for a single person)
  • Coverage will continue for the over 550,000 beneficiaries enrolled in a county LIHP
  • Federal dollars coming to California’s economy will be maximized
  • Expansion will create a culture of coverage for the state’s lowest income individuals

Important Benefits of Expansion

Expanding Medi-Cal will bring coverage to over 1.4 million people who would be newly eligible for the program, starting January 1, 2014. Key benefits of expansion include:

  • Providing California’s lowest-income residents with comprehensive benefits and nominal cost sharing
  • Allowing California’s Low Income Health Program (LIHP) enrollees, now totaling over 550,000 individuals, to continue and maintain their health coverage
  • Reliving the strain on California’s safety net providers, such as community clinics and health centers, and hospital emergency rooms, who currently serve a large portion of the uninsured
  • Infusing federal dollars into the state that will help create and sustain jobs in the health care workforce.

 

RESOURCES

CPCA hosts webinar on Medi-Cal Managed Care Proposed Rule

On Friday, July 10 CPCA staff hosted a webinar providing an overview of the elements within CMS’ sweeping new Medi-Cal managed care proposed rule which would impact CCHCs.  CCHCs are invited to weigh in on CPCA’s comments on the rule.  For questions, comments, or feedback, contact Meaghan McCAmman at mmccamman@cpca.org.  for a recording of Friday’s webinar click here.

Medi-Cal Billing and Reconciliation Webinar

On April 23, 2013, the Department of Health Care Services (DHCS) and Xerox in collaboration with CPCA hosted a webinar on Medi-Cal Billing and Reconciliation for Code 18 (Medi-Cal Managed Care) and Code 20 (Capitated Medicare Advantage Plan).  The webinar provided an introduction to establishing a Code 18 /20 rates, annual reconciliation and Medi-Cal claims billing in the Medi-Cal Managed Care environment.

Please find the slides and recording from the webinar on DHCS Primary & Rural Health Division’s website at the below link:

http://www.dhcs.ca.gov/services/rural/Pages/PRHMeetingsandWebinars.aspx

CPCA strongly encourages all health centers that are part of the new Medi-Cal Managed Care expansion to listen to this webinar.  The information is also valuable to health centers who have been part of the Medi-Cal Managed Care world but could use a refresher.

The Kaiser Family Foundation’s Visualizing Health Policy infographic considers who will be covered under the Affordable Care Act’s Medicaid expansion provisions, which states have opted to implement or not implement the ACA Medicaid expansion, the proportion of nonelderly uninsured individuals who will likely remain uninsured, how Medicaid will streamline the enrollment process, and how the cost of the Medicaid will be funded by the federal and state governments.  Please click here for a pdf version of the infographic.

CMS Rules Governing Changes to Medicaid Eligibility & Enrollment Under the ACA

Two new briefs from the Kaiser Family Foundation’s Commission on Medicaid and the Uninsured examine changes to Medicaid eligibility and enrollment rules under the Affordable Care Act, and how such changes are expected to affect those covered by the program, including people with disabilities.

One brief provides a summary of the Centers for Medicare and Medicaid Services’ (CMS) March 23, 2012 final rule to implement the ACA provisions relating to Medicaid eligibility, enrollment simplification and coordination. The rule, which is effective Jan. 1, 2014, lays out procedures for states to implement the Medicaid expansion and the streamlined and integrated eligibility and enrollment system created under the ACA. Achieving this goal will require substantial process and system changes among state Medicaid agencies and close coordination between Medicaid, the new health insurance Exchanges and other insurance affordability programs.

A companion brief provides a short summary of Medicaid eligibility and benefits for people with disabilities today and explains how they will be affected by the ACA in light of CMS’s new regulations. Provisions of the new Exchange regulations are discussed briefly to the extent that they related to Medicaid eligibility determinations for people with disabilities.

Documents

If you have any questions about Medicaid Expansion, please contact Beth Malinowski, Assistant Director of Policy at bmalinowski@cpca.org.

 


2017 Annual Sponsors