Major Highlights of California State Budget and Medi-Cal Expansion
by Khae Saetern
On June 27th, 2013 Governor Brown signed the 2013-14 California State Budget and historic Medi-Cal Expansion bills which includes these major highlights:
Partial Restoration of Adult Dental Benefit in Medi-Cal
The budget includes the partial restoration of the adult dental benefit under Medi-Cal, with coverage beginning no later than May 2014. Services that will be covered are preventative services, dental restorations, and full dentures. The adult dental benefit will be available to the new Medi-Cal Expansion population and those who are currently Medi-Cal eligible. In a more recent development, the 9th U.S. Circuit Court of Appeals ruled that dental, optometry, podiatry, and chiropractic benefits are core FQHC benefits and that California’s elimination of those benefits in 2009 was illegal. The State of California may appeal the decision; the California Primary Care Association (CPCA) is closely monitoring the situation. In the meantime, health centers can plan at minimum for a partial restoration of the adult dental benefit in 2014.
Health Coverage for More Patients under Medi-Cal Expansion
Along with the state budget, Medi-Cal will be fully expanded to cover most individuals up to 138% FPL ($15,800/year for an individual & $32,500/year for a family of 4). Over 40,000 HealthPAC Medi-Cal Eligible (MCE) patients will automatically transition to Medi-Cal January 1st. For this reason, it is important that health centers not slow down and keep enrolling all eligible patients into HealthPAC MCE through the end of this year.
Recent legal permanent residents (LPRs) with U.S residency less than 5 years (those currently eligible for Medi-Cal, including parents) will continue to be Medi-Cal eligible. Recent LPRs who are childless adults with incomes less than 138% FPL will be eligible for Covered CA, the new health insurance marketplace, with Medi-Cal as a benefits and affordability wrap-around (i.e. secondary insurance).
HealthPAC and the Remaining Uninsured
Unfortunately, the state budget also includes a cut to county health re-alignment funding (vehicle license fees and sales tax revenue) that could affect HealthPAC and its capacity to serve the remaining uninsured in the future. The Alameda Heath Consortium is working closely with Alameda County Health Care Services Agency and statewide advocacy groups to ensure that those who will remain uninsured will continue to be served.
For further questions or comments, please contact Khae Saetern, Project Coordinator, Policy and Planning at the Alameda Health Consortium at ksaetern@alamedahealthconsortium.org.