Medi-Cal woes leave CA hurting

doctor and patient, flickrA victim of its own success, California’s popular Medi-Cal program has rapidly swelled to a large enough size to malfunction. It’s known as Medicaid in the rest of the country and provides medical care to poor people.

Mounting woes — from applicant backlogs to outdated regulations — have raised serious concerns among analysts and policymakers.

In part, the challenges facing the Medi-Cal system came about because of administrative changes triggered by the federal Affordable Care Act, or Obamacare. Here it’s called Covered California. As reported, a combination of cuts in federal and state budgetary subsidies boosted provider costs.

“A provision of Obamacare hiked the rates for primary care doctors to the substantially higher Medicare rates for two years, but those increases ended on Dec. 31,” reported the San Jose Mercury News. “A second blow came last month when the state cut the Medi-Cal reimbursement rate by another 10 percent, a reduction approved by California lawmakers in 2011 but delayed in a court battle that doctors ultimately lost.”

But the ACA has made an even greater impact on California’s health care challenges by ballooning the population accessing Medi-Cal benefits. As the Mercury News reported, Obamacare opened the floodgates in Jan. 2014, resulting in 2.7 million more recipients to date.

California’s expanded recipient group now makes up 17 percent of total national Obamacare enrollment, even though California’s overall population is just 12 percent of the U.S. total.

State health officials, according to the Mercury News, have concluded that by the middle of 2016, “more than 12.2 million people — nearly a third of all Californians — will be on Medi-Cal.” Meanwhile, the program already consumes about two-thirds of California state-government spending on health and human services overall.

Budgetary fears

For both Gov. Jerry Brown and Sacramento legislators, these trend lines have raised sharp worries, as McKnight’s news service reported:

“State lawmakers this week said the latest enrollment news is alarming, and that even if a new pending rate request hike goes through, there is concern the state will run out of funding to care for its Medicaid recipients. State Medicaid costs are up 4.3 percent this year while federal share of costs for new enrollees will begin dropping in 2016, according to Gov. Jerry Brown.”

Brown has made an effort to head some costs off at the pass in his budget plan. According to State of Reform, a health-care think tank, “Brown has earmarked $2 billion in total funds ($943.2 million General Fund dollars) to cover mandatory Medi-Cal expansion.”

But pressure to change the budgetary calculus in California’s favor has intensified.

Reducing access

The big picture for Medi-Cal has officeholders and policymakers so nervous because of the ripple effects of increased costs and recipient rolls. State of Reform observed:

“In addition to Medi-Cal primary cuts making it potentially impossible for new patients to find physicians, President Barack Obama’s executive action will make approximately 1 million undocumented immigrants in California eligible for health insurance tax subsidies.”

That has critics warning access to doctors could decrease sharply. In a sobering report issued by the Legislative Analyst’s Office, the impact of the president’s actions was incalculable:

“The benefits received by undocumented immigrants through these programs are almost entirely funded by the state and would therefore result in additional General Fund costs of an unknown amount. The General Fund costs to provide state–funded benefits to this population are unknown at this time.”

With the federal government putting the squeeze on California’s budget, state doctors have become increasingly scarce.

“There are mounting concerns there will not be enough plan doctors to accommodate the enrollment surge,” according to McKnight’s. “One recent study found that only 57 percent of the state’s primary care doctors accept new Medi-Cal patients.”

As a result, increasing numbers of recipients have been winding up in the ER. As the Fresno Bee observed, that transfer of burdens has undermined the claim advanced by Obamacare proponents “that patients with insurance would have primary care doctors to take care of them and less reason to use expensive and overcrowded hospital emergency rooms.”

Although experts have not determined the likely extent of doctors’ unwillingness to treat Medi-Cal patients, California lawmakers have begun to brace for the worst: a substantial budgetary increase that will not be covered by the federal government.

Instead, the higher health tab may have to be absorbed by increased taxes, cuts in other budget areas, or both.


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  1. Dude
    Dude 20 February, 2015, 11:24

    “Instead…..increased taxes”. Fat chance Governor Moonbeam! Any and all taxes have to be voted on by us citizens. You had a press conference a while back and stated that ‘everybody was legal and welcome on that day. Well, its time to pay the piper. You get the tab for inviting all the illegal aliens here……not us California/US citizens. Maybe you can steal some cash from the “Save the delta smelt” fund. You remember, the stupid fish you saved at the expense of all those AMERICAN citizen farmers in California. You can’t make up this kind of stupid.

    Reply this comment
  2. Sean
    Sean 20 February, 2015, 11:35

    Don’t forget the impact on people with healthcare insurance from private companies. The losses from treating MediCal patients will show up in the bills for people whose healthcare is paid for privately or from regular commercial insurance providers. These transfer payments through the healthcare system will occur base on head count and won’t take into consideration anyone’s ability to pay. It may be the most regressive tax ever levied on the citizens of the state. Let’s see, 12.2 million people x $8750 per person x 40% of the non-reimbursed MediCal bill is $42.7 billion. Divide that by the 22 million people covered with private healthcare plans is about $1940 per person. Let’s round that up to $2000 per person because Medicare doesn’t pay the full cost either. But don’t worry, your health insurance bill won’t go up by $2k because you’ve already been covering about half that prior to the ACA expansion of Medicaid.

    Reply this comment
  3. bob
    bob 20 February, 2015, 13:08

    The Sheeple wanted Obammiecare and they’re getting it good and hard.

    And the libtards and trough feeders that infest this blog will tell us it’s all good just as long as we can raise taxes.

    Reply this comment
    NTHEOC 20 February, 2015, 17:20

    “Instead…..increased taxes”. Fat chance Governor Moonbeam! Any and all taxes have to be voted on by us citizens
    Fat chance huh??? The citizens of California always do the right thing and we should have no problem increasing some taxes. There is more than enough money in this State to go around and help those less fortunate! And I’m glad you were LUCKY enough to be born here, some weren’t and just want a better life. We have people in this state dropping 30 million for Laguna beach homes on the hill and more millionaires than anywhere so California should have no problem helping the poor.

    Reply this comment
    • bob
      bob 20 February, 2015, 19:28

      “…and we should have no problem increasing some taxes.”

      Spoken like a true trough feeder. Instead how about we clip your 6 figure pension?

      Reply this comment
    • bob
      bob 20 February, 2015, 19:30

      I said “And the libtards and trough feeders that infest this blog will tell us it’s all good just as long as we can raise taxes.”

      And in true fashion you responded with “we should have no problem increasing some taxes.”

      Reply this comment
    • Dork
      Dork 23 February, 2015, 10:58

      “We have people in this state dropping 30 million for Laguna beach homes on the hill and more millionaires than anywhere”

      It is THEIR MONEY and you moochers do not have a claim to it. Go start your own business and earn your own money. They earned, they deserve to be able to spend it any damned way they choose.

      Sig Heil

      Reply this comment
      • NTHEOC
        NTHEOC 23 February, 2015, 11:58

        Dork, most of them did not EARN it. They worked crooked back door deals, raped the workers, find tax loopholes and avoid paying their share, these are the ones who our govt needs to go after and tax them to the max!! There is no reason anyone should have the ability to be that wealthy while we have good people, veterans and others starving in the streets with no healthcare. We need to close the gap of the income inequality and tax these people down as far as we can!!!!!!

        Reply this comment
      • NTHEOC
        NTHEOC 23 February, 2015, 12:01

        It is THEIR MONEY and you moochers do not have a claim to it. They earned.
        I’ll remember that the very next time you have anything to say about public employee’s pensions,pay,or benefits! Lol

        Reply this comment
    NTHEOC 20 February, 2015, 17:25

    Give The new healthcare system a couple years and hopefully we will be on a full scale nationalized healthcare system like places such as Finland,etc. If that takes raising taxes till it works then so be it!!

    Reply this comment
    • bob
      bob 20 February, 2015, 19:31

      Tax’em to the stone age, son!

      Reply this comment
    • Dork
      Dork 21 February, 2015, 11:28

      SIg Heil!!

      Reply this comment
    • Donkey
      Donkey 21 February, 2015, 18:00

      Ntheoc, you are a box of rocks!! Finland is not taking care of 25 million Mexicans, Salvadorans, and every other Latino state south of our borders!!! 🙂

      Reply this comment
      • NTHEOC
        NTHEOC 21 February, 2015, 22:14

        Wow donkey!!! What a racist ugly thing to say about people wanting a better life and did not have the good fortune to be born here like you. We have more than enough resources and money to help those in need. If our tax system didn’t cater to the wealthy hogs because of lower top marginal income tax rates more of those in need of healthcare could be helped!

        Reply this comment
        • conservativeprof
          conservativeprof 22 February, 2015, 20:23

          Let’s have open borders. I think that several billion would like to come to California especially with free health care, housing, food stamps, Obama phones, utility subsidies, tax credits, direct welfare payments, … Your comment about taxes is ignorant and class warfare. Please open your wallet.

          Reply this comment
  6. Queeg
    Queeg 20 February, 2015, 22:40


    Obamacare scares the crap out of folks…..forms, penalities, copays, deductibles, bad net stuff, lots of eyes on your records! And those creepy navigators. Ugh!

    Heck. ER it. Or Medical …, no fuss just find someone to treat you.

    Reply this comment
  7. Dork
    Dork 21 February, 2015, 11:26

    This is such an easy fix for the Governor, just pass a law mandating that ALL COSTS to any person without a valid verified social security number and a valid verified STATE Income Tax return shall be paid for by PUBLIC EMPLOYEES. Take it right out of their check every week. Problem Solved.

    Reply this comment
    • Ulysses Uhaul
      Ulysses Uhaul 21 February, 2015, 12:38


      This is serious stuff and fantasy is unwelcome about health……California almost has more poor people than the middle class.

      Reply this comment
      • Donkey
        Donkey 21 February, 2015, 19:15

        He is serious Ahaul, let the RAGWUS feeders pay the bill, they are stealing all the tax dollars as I write. “Socialism can provide you shelter, fill your belly with beans, treat you when you’re ill. All the things guaranteed to a prisoner or a slave.” Ronald Regan.
        Quit being a mooch Ahaul and get a job that pays for a real service or product. 🙂

        Reply this comment
      • Dork
        Dork 23 February, 2015, 10:53

        Unfortunately I am DEAD SERIOUS, if you want all these migrant peasants, then get out your checkbook and PAY FOR them yourself.
        Sig Heil

        Reply this comment
  8. Bill Gore
    Bill Gore 21 February, 2015, 20:03

    Screw the ACA-DO NOT COMPLY! If your employer provides full coverage then don’t worry about it. If they don’t, then don’t worry about it! Do as the ‘sin documentos’ do: totally BLOW OFF everything and just show up at the ER when something hurts. Period. Pretend you are from serbo-croatia and you dont speak a word of english….Complain about the pain. They WILL treat you…

    Reply this comment
    • NTHEOC
      NTHEOC 21 February, 2015, 22:16

      Good luck with that plan billy!! Let us know how it works out for you…..

      Reply this comment
  9. californianative
    californianative 22 February, 2015, 02:03

    Bill Gore is correct. Anybody that shows up with a bona fide medical complaint to an ED gets whatever they need, including dialysis and heart surgery. The Hospitals are too afraid of any bad press from not treating sick people. They don’t want any CMS ( Center for Medicare Services) types snooping around in the books anymore than is required. I know, I work in Healthcare.

    Reply this comment
    • NTHEOC
      NTHEOC 22 February, 2015, 07:09

      I’m well aware of how our healthcare system works and we do not turn anyone away who needs treatment at an ER. But, if you are just going with that plan because of spite and dislike of the healthcare system we have then you could be piling up huge medical bills,bad credit,and fines. So why ignore the ACA…..

      Reply this comment
      • Queeg
        Queeg 22 February, 2015, 08:09

        Rolling over Comrade is not an option.. There is little money out there within the ravaged middle class.

        Reply this comment
      • californianative
        californianative 22 February, 2015, 08:46

        Billy might care but if you are part of the $10/hr labor force and you don’t own a mortgage attached to a house, you have no money in the bank, what are they going to do? Put a lien on your used underwear?

        Reply this comment
      • bullwinkled
        bullwinkled 22 February, 2015, 15:18

        All of south america could move to california and dumb bastards like you would pay for it. I am willing to bet you are a government worker, another POS killing california.

        Reply this comment
  10. californianative
    californianative 22 February, 2015, 02:18

    One example. An illegal alien spent over 6 months living in the hospital where I work. Room, board, dialysis three times/week, labs, daily rounding by physicians, etc. All free to him. The hospital case managers were in contact with the Mexican Consulate on a weekly basis trying to get them to take this guy back. They had zero interest. You can’t discharge a dialysis patient from the hospital without arranging an outpatient dialysis chair. You can’t get an outpatient chair without a payor source. The hospital finally made some arrangement to provide outpatient dialysis for him for a specified period of time ( I think 6 months or so) just to get him out of the hospital. No cost to the patient. Hospital just hoping that the next time he got in trouble ( after the 6 month period when his outpatient dialysis chair ” evaporated” ) he would go somewhere else. Obama thinks the hospitals are so rich they can deal with this stuff on their own. They can until they run out of money. Then the citizens served by those hospitals are out of luck when those hospitals close due to bankruptcy.

    Reply this comment
    • Bill Gore
      Bill Gore 23 February, 2015, 20:45

      Exactly my point. That patient BLEW OFF every rule, law, responsibility and received FREE state of the art medical care.The ACA, for all us good little law-abiding dutiful tax-paying Dudley Do Rights, has dramatically raised premiums and deductibles. Since full-on socialism is what we all demand and need, the ACA should be rewritten as single payer (gubmint) blanket catastrophic free coverage for everyone with a social security number. It would be a TINY percentage of the money they blow annually on the military industrial complex. And even then, the sin documentos, addicted as they are to blowing off EVERY law , would refuse to get social sec. numbers. …

      Reply this comment
  11. desmond
    desmond 22 February, 2015, 04:42

    The governor is sh;[email protected]$g about his legacy. He will leave with a state approaching 40% on med cal, 60 percent of students on free or assisted lunch/breakfast Add the govt retirees cost. He has to think about his father and his view. “Jerry, you really f’d this up.”

    Reply this comment
  12. johnGalt
    johnGalt 23 February, 2015, 11:57

    How absurd! When your initial statement is “Medi-Cal is a success,” how many people do you expect will keep reading. Like most of the other socialist crap permeating Kaliformia, it’s a failure… for the very reasons you declare it a success!

    Why not give away free Teslas to everyone who signs up? Just think how many people you’d have then! LOL

    Reply this comment
    • Bill Gore
      Bill Gore 23 February, 2015, 21:06

      The Mexican Constitution has enshrined the following rights: the right to housing, the right to food and the right to medical care. In practice the waiting list for housing often extends for 20 years or more, the right to food entails lining up for your 3 tortillas per person per day, and the right to medical care means going to free clinics that are, let’s say, ‘disturbing’….Now compare this level of free stuff with the free stuff you can get in California: free section 8 housing (an apartment 3 blocks from the trolley), EBT/SNAP card for family shopping at COSTCO, and oh yeah you can walk right in the front door at Scripps Hospital and get a free liver transplant/brain surgery/whatever. So would you stay in Sonora or Michoacan?

      Reply this comment
  13. Strat
    Strat 4 May, 2015, 17:09

    It should be illegal (if not common sense) for an elected U.S. body to transfer one dollar of citizen tax money into the pocket of a citizen of another country who snuck into this country illegally. How can anyone defend that?

    Reply this comment

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