Time Remains to Preserve Meaningful Access to Care
Legislature’s Budget Deal Provides Opening to Avoid Jeopardizing Care for Nearly 2 Million Californians

SACRAMENTO, CA – With the Legislature set to negotiate a final budget with the Governor by the end of the month, the two-party budget deal just released by the Legislature provides the opportunity for preserving access to care for low-income undocumented Californians. The Legislature remains open to pursuing an alternative to shifting nearly 2 million Medi-Cal enrollees into a fragmented system where health care coverage is in name only.

The alternative, advanced by the Local Health Plans of California (LHPC) and a broad coalition of state and local safety net providers and health plans, local government, and advocates for vulnerable populations, maintains access to critical primary and specialty care services, care coordination, preserves provider rates for managed care services, and avoids the disruption of care for vulnerable Medi-Cal members. It complies with new federal rules and achieves budget savings without moving undocumented populations into lesser care.  

By contrast, the Administration’s May budget proposal called for moving these Medi-Cal members into the antiquated Medi-Cal fee-for-service (FFS) system that offers few provider options and no care coordination, forcing the population to seek higher cost emergency care rather than preventive services.

“We deeply appreciate the additional time the Legislature has provided which allows for consideration of a thoughtful approach that preserves access to care for nearly 2 million Californians,” said LHPC CEO Linnea Koopmans. “In short order, this coalition presented a strong alternative that avoids major disruptions of critical health care services for vulnerable children, adults, and older adults.”

Under this proposed model, undocumented Medi-Cal enrollees would remain connected to their existing health plan, provider network, care coordination, member services, and access supports, while the state would directly pay for the services that are eligible for federal funding to comply with new federal guidance.

Under FFS, enrollees would be left to navigate their health care on their own, with no organization accountable for ensuring their access. Those receiving specialty care, cancer treatment, behavioral health services, preventive health care, and other critical services could lose the providers they know and trust. Hospitals already under strain would see a sharp rise in emergency department visits and hospital inpatient stays as people forgo needed care.

“We can do better. Rather than creating a system of sub-par health care access for a portion of the population, with a $190 million investment lawmakers can support continuity of care and retain critical health care infrastructure,” Koopmans continued. “We look forward to working closely with the Legislature and the Administration over the next two weeks on a pathway to preserve access to care.”

Health care is on the line for Californians needing critical services, including:

• 689,000 UIS individuals receiving specialty care
• 34,000 UIS individuals with a cancer diagnosis
• 70,000 UIS individuals receiving behavioral health services
• 16,000 UIS individuals receiving dialysis
• 106,000 UIS children receiving well-child visits

Along with LHPC, statewide coalition members include the Latino Caucus of California Counties, California Primary Care Association, California Association of Public Hospitals and Health Systems, Private Essential Access Community Hospitals, California Medical Association, California Association of Health Plans, County Behavioral Health Directors Association of California, America’s Physician Groups, First 5 Association of California, and California Academy of Family Physicians.

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 healthcare 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.

Media Contact:
Nicole Evans
nevans@nkestrategies.com
(916) 502-2756