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Healthy Families

Health plans air concerns amid changes to kids' coverage

Under a budget-paring plan crafted by Gov. Jerry Brown and approved by lawmakers, 870,000 children who were covered by the Healthy Families program will be moved to Medi-Cal in phases starting Jan. 1. But it remains unclear whether a health plan serving Sacramento, Fresno, San Diego and Los Angeles counties will have enough doctors to accept the children.

Health Net, which covers about 86,000 children, notified the state that it can’t say how many of its doctors will continue to see children after they are moved from the better-paying Healthy Families program to Medi-Cal, a Medicaid program that pays some of the nation’s lowest reimbursement rates.

CalViva, a plan that contracts with Health Net to provide care to nearly 15,000 clients in Fresno, Kings and Madera counties, also reported similar concerns.

“That’s a lot of children who would be affected if there are problems in the health plans,” said Michele Stillwell-Parvensky, a policy and communications associate with the Children's Defense Fund – California.

In a report published Nov. 1, Health Net said it could not determine its doctors' willingness to take on Medi-Cal clients without seeing rates under the emerging plan.

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Kids' access to health care a concern under Brown's budget

Low-income children in rural California communities are in jeopardy of losing their doctors and health care plans under Gov. Jerry Brown's budget proposal, state lawmakers, doctors and health advocates say.

The governor is proposing to transfer nearly 900,000 children enrolled in Healthy Families, the state’s Children’s Health Insurance Program, to Medi-Cal – a program aimed at serving the state’s poorest families, seniors and disabled residents.

While combining the two programs might be a painless transition for children in urban areas with doctors who typically provide care to both Healthy Families and Medi-Cal patients, the transfer could severely limit access to health care for those on the outskirts.

“In the more rural areas or outlying areas, there would be quite a loss or quite a strain,” said Stuart Cohen, a San Diego pediatrician and California chairman-elect for the American Academy of Pediatrics. “Access to care would be a huge issue.”

And there would not be much incentive for rural doctors at full capacity to continue caring for their Healthy Families children if they have not already agreed to serve Medi-Cal patients, Cohen said.

 

The governor’s proposal not only forces Healthy Families patients to move to Medi-Cal, but it also would require doctors to accept Medi-Cal’s monthly reimbursement – an average cut of nearly 20 percent.

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State revisits budget as prior cuts hit poor, disabled

Gov. Jerry Brown unveiled budget proposals Monday that were relatively mild compared to cuts suggested and enacted in recent years, buoyed by an unexpected windfall from the state’s wealthiest taxpayers.

But even as some advocates for the poor and disabled can breathe a sigh of relief, one group is drawing attention to the wave of impacts caused by billions in cuts in recent years.

The nonpartisan California Budget Project last week issued fact sheets on recent cuts to programs that give stipends to the poor and disabled, families going from welfare to work and a health insurance program for needy kids.

Jean Ross, executive director of the project, said the idea came from one result of a Field Poll question showing that about half the state’s residents felt no impact from California budget cuts.

"We were trying to document that there had been large cuts and large amounts of dollars lost," Ross said. 

Her staff set out to examine how several programs were hit and how each county may have swaths of people struggling to cover costs.

Here are some of their findings:

Supplemental Security Income/State Supplementary Payment

The Supplemental Security Income program is meant to give cash assistance to seniors and the disabled to pay for basic expenses such as housing and food.

Budget Project staff say $4.6 billion has been cut [PDF] from the program since the 2008-09 budget year.

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