SACRAMENTO — A statewide health care safety net coalition today expressed concern about the transition of nearly 2 million Medi-Cal enrollees with unsatisfactory immigration status (UIS) from managed care plans to state Fee-For-Service and urged state leaders to continue working toward a durable solution to preserve health care.

The final state budget includes an investment in care coordination for UIS members who may transition to Medi-Cal fee-for-service; however, it does not adopt the alternative proposal that would have preserved access to care through local managed care. The coalition expressed disappointment in the final state budget and warned the Legislature and Administration that this population will need ongoing support, navigation, and access to care.

The coalition remains deeply concerned that moving UIS members from managed care into fee-for-service will reduce access to care, disrupt provider relationships, and place additional pressure on clinics, physicians, hospitals, counties, and community-based organizations. Managed care provides member services, robust provider networks, preventive care, and accountability that fee-for-service cannot easily replicate.

The coalition will continue working with the Legislature, the Administration, and the Department of Health Care Services to advocate for affected members and pursue future opportunities to restore comprehensive, coordinated care for the UIS population.

A broad range of health care professionals, safety net providers, local health plans, and advocates joined together throughout the budget process to protect meaningful health care access in California.

The following are statements from coalition members who worked to protect Medi-Cal access for UIS members.

Marina Owen, Local Health Plans of California (LHPC) Board Chair and CenCal Health CEO

“This outcome leaves nearly 2 million people at risk of losing access to care that makes health insurance coverage meaningful: trusted providers, prevention, and accountability. We appreciate the Legislature’s investment in care coordination and the efforts of many legislative leaders who worked to soften the impact of this transition, but we remain deeply concerned that fee-for-service cannot replicate the local systems of care that have been built over decades. I am profoundly grateful to the broad coalition of statewide and local organizations that came together around a shared belief: we must preserve local care, maintain access, and protect the safety net. We remain steadfast in our commitment to restoring comprehensive, coordinated care for UIS members in the years ahead.”

René Bravo, M.D., California Medical Association President (CMA)

“California has come a long way in helping vulnerable patients access care in their communities. Cutting funding for nearly 2 million Medi-Cal enrollees is a significant step backward. This decision will disrupt care for many patients and make it more difficult for them to get timely and necessary care.”

Katie Rodriguez, Interim President and CEO of the California Association of Public Hospitals and Health Systems (CAPH)

“As millions of individuals lose Medi-Cal coverage, our emergency rooms will be the front lines of a humanitarian crisis. Public hospital systems serve anyone who walks through their doors but between H.R. 1 and the state budget’s moving the UIS population to fee-for-service Medi-Cal, we are concerned that these patients will show up much sicker as public hospital systems continue to navigate billions in cuts. We are grateful for state leaders’ support for the public hospital system to help keep our doors open. It is an important down payment on a long-term solution.”

Francisco J. Silva, Esq., CEO, CPCA Advocates

“Clinics are mission-bound to provide care to all who need it, and we appreciate the critical investments preserving full health center payments for immigrants and new funding for health enrollment navigators. However, the retreat from keeping patients in managed care will make delivering care more difficult for vulnerable patients. As we look to the future, we are hopeful that we can rebound with the support of the Legislature and the next Administration.”

Along with LHPC, statewide coalition members include the Latino Caucus of California Counties, CPCA Advocates, CAPH, Private Essential Access Community Hospitals, CMA, California Association of Health Plans, California Alliance of Child and Family Services, District Hospital Leadership Forum, Children Now, County Behavioral Health Directors Association of California, Latinx Physicians of California, Medi-Cal CBO Coalition, America’s Physician Groups, First 5 Association of California, California Academy of Family Physicians, and Steinberg Institute.

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About LHPC

Local Health Plans of California (LHPC) is a statewide trade association that represents all 17 of the community-based, not-for-profit health plans that provide access to critical and comprehensive health care services for low-income populations enrolled in California’s Medicaid program, “Medi-Cal,” in 51 out of 58 counties in the state. With 9.1 million enrollees, our plans serve approximately 70 percent of all Medi-Cal managed care beneficiaries. More here.

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