Keeping You Connected

The SFMMS keeps you up to date on the latest news,
policy developments, and events

San Francisco Marin Medical Society Blog

Special Session on Medi-Cal Financing Underway in the Capitol



In June, Governor Jerry Brown convened a special legislative session on health care financing. Specifically, legislators will be working to come up with new funding for developmental disability services, in-home supportive services, and the Medi-Cal program, which is facing a shortfall of at least $1.1 billion through the loss of the managed care organization (MCO) tax.

Since 2005, the state has taxed MCOs and used the money to cover the costs of provider reimbursement. However, federal officials informed California in 2014 that its MCO tax structure was not compliant with new federal requirements. The loss of the MCO tax and the federal matching funds would mean the loss of over $2 billion for the Medi-Cal program.

The budget that Brown introduced in January proposed a new MCO tax that would conform to the new federal requirements, but health plans objected to the new tax and the legislature failed to adopt the proposal.

The special session will look at sources of funding, from another MCO tax to alternative sources. Legislators will also tackle other issues, including:

  • How to restore cuts made to Medi-Cal provider reimbursement rates.
  • How to finance the Medi-Cal program when the state must begin paying in 2017 for 10% of Medi-Cal enrollees who are “newly eligible” under the Affordable Care Act.
  • How to pay for a court-ordered restoration of a 7% cut in In-Home Supportive Service rates.

The special sessions began in June with informational hearings, but the hard work isn’t expected to begin until late August after the summer recess. SFMS and CMA continue to work with its legislative allies and coalitions to push the issue of reimbursement rates and patient access over the finish line.

Medi-Cal currently covers approximately one-third of the population of the state of California, 12.3 million people. California has ranked among the bottom three states in the nation for Medicaid reimbursements since 2011. Low reimbursement rates have forced many of California’s providers to stop seeing Medi-Cal patients. As a result, more than half of Medi-Cal patients report difficulty finding a doctor. SFMS and CMA, along with We Care for California coalition partners, are committed to ensuring that Medi-Cal is not a broken promise of access to care for millions of Californians.



Comments are closed.

Archives