Officials defend planned Medi-Cal cuts California health officials defended a controversial plan released earlier this week to overhaul Medi-Cal — the state's health insurance program for 6.6 million poor — in a meeting with stakeholders Thursday. Among the most contentious cost-saving measures proposed by the Schwarzenegger administration are requiring some beneficiaries to pay premiums; reducing adult dental benefits; and moving the aged, blind and disabled into managed care. "We believe we have brought forth a responsible and reasonable approach to this program," Kim Belshe, Health and Human Services Agency secretary, told the attendees in Sacramento. The state held 25 meetings with community health officials, hospitals and consumer groups last spring and summer to hammer out a reform proposal. Looking at the final plan, some of those groups expressed concern that changes could hurt California's most vulnerable populations. The state is proposing collecting premiums for the 550,000 beneficiaries with households with incomes of at least 100 percent of the poverty level. Premiums for children would be $4 a month, for adults $10 a month and up to $27 per family. For instance, a family of one adult and two children making $15,684 a year would pay $216 annually in Medi-Cal premiums. "Clearly there will be some impact of people falling off the rolls due to the premiums," said Anthony Wright, executive director of Health Access California. State officials estimate that 20 percent of people would leave the program after premiums are added, but they had no firm numbers. Collecting the premiums will cost the state about $8 million a year. The state is expected to save $11 million initially when the program begins in January 2007, with more savings as the program gets under way. In defending the premiums, Belshe said she wanted Medi-Cal to look more like employer-based coverage to givepeople a sense of personal responsibility and dignity. "You can't assume nonpayment of premiums means that people couldn't pay," Belshe said. "As you move up the income ladder, you're not talking about a welfare program but a working families program." All changes to Medi-Cal being proposed require a federal waiver and approval by the state Legislature. Belshe said a federal waiver has been submitted, and the state has not yet received a response. Wendy Perterson, program coordinator of the Senior Services Coalition of Alameda County, wanted to know what would stop the state from increasing premiums further once the waiver is approved. State health officials said any more changes would be highly unlikely. A plan to cap adult dental benefits to $1,000 a year for about 3 million Medi-Cal recipients starting in August also met some resistance. The California Dental Association estimates that such a cap would cover dentures, which run about $900, but not treatment and follow-up care necessary for seniors who switch to dentures. State health officials said they would consider waiving those fees. Emergency and hospital dental services also will be waived. Advocates for the 554,000 aged, blind and disabled, who the state plans to move into managed care, said those populations could lose access to services and specialty physicians. Dan Kysor of the Hayward-based California Council of the Blind said transportation could be an issue, too, if the blind have to travel farther for their care. Still, some said they were relieved that other cuts — such as not requiring co-payments for doctor's visits or restricting enrollment — weren't in the final plan. Medi-Cal is the state's second largest expenditure after K-12 education and Schwarzenegger has made it a priority to trim the program. "Candidly, this proposal is a lot less onerous than we feared," said Gary Passmore of the Congress of California Seniors. |