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.