Medi-Cal Access - National Multiple Sclerosis Society

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CA State Issue:

Medi-Cal Access

Reduction in Medi-Cal Provider Rates = Reduced Access to Care

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About This Issue

California has among the lowest Medicaid (Medi-Cal in California) reimbursement rates in the nation. In 2011, the Legislature and the Governor reduced Medi-Cal reimbursement rates to providers by 10 percent as part of a larger effort to close a multibillion-dollar state deficit. Even with the California economy doing better and the state seeing billion dollar surpluses, the Governor’s FY 2014-15 budget maintains those Medi-Cal provider cuts. Because of these reductions in reimbursement rates, doctors may opt out of providing health care to Medi-Cal beneficiaries. The reductions may make it even harder for these patients to get medication, medical equipment and appointments with specialists. Reduction in Medi-Cal Provider Rates = Reduced Access to Care

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Advocates are trying to reverse these cuts. They are concerned that Medi-Cal patients will not get the care they need. In order to make this case, we need stories from Medi-Cal patients that describe any problems or challenges they have had in accessing the care they need.

Please email Stewart Ferry at stewart.ferry@nmss.org to share any Medi-Cal provider access issues you are  experiencing.

Please email Stewart Ferry at stewart.ferry@nmss.org to share any Medi-Cal provider access issues you are  experiencing.

California Information

In 2013, the Legislature passed and the Governor signed AB1x1 (Speaker Perez, Chapter 3, Statutes of 2013) and SB1x1 (Hernandez, Chapter 4, Statutes of 2013) that expands Medi-Cal to all legal residents up to 138% of the federal poverty level ($15,856 for an individual in 2013) to include adults without children under 18 at home. Medi-Cal eligibility is now based on income, not assets, with no assets test. The bills put in place eligibility and enrollment reforms to make it easier to get on and stay on Medi-Cal coverage. The Governor’s proposed FY 2014-15 budget includes funding to support the expansion of Medi-Cal in California.

For the three-month period from October to December 2013, a total of 584,000 applicants were determined to be likely eligible for Medi-Cal through the Covered California enrollment portal. There are many paths to enroll in Covered California health insurance plans and in Medi-Cal, including in-person enrollment with assistance from trained Certified Insurance Agents, Certified Enrollment Counselors, county eligibility workers, as well as self-enrollment online.

Consumers can received enrollment assistance at CoveredCA.com.
 

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