KHN Morning Briefing

Summaries of health policy coverage from major news organizations

In Calif., Will Court-OK’d Pay Reductions Make It Harder For Poor To Get Care?

Some worry that a Medicaid expansion in California could be hampered by reduced payments to Medi-Cal providers that a court approved last week, making it more difficult for the poor to find specialists.

Los Angeles Times: Advocacy Groups Coming Hat In Hand To A Less-Strapped Sacramento
The California Medical Assn. also wants more funding as the state prepares to enlarge health care coverage. David Ford, the group's associate director of medical and regulatory policy, said administrators will need more staff to process an influx of newly covered Californians. "We have to be ramping up," he said. Advocates worry that the new health care law will be undermined in California because the state's Medi-Cal cuts could make it harder for the poor to get care. A federal appeals court ruled Thursday that the state can reduce payments to doctors and others who care for Medi-Cal patients; provider groups say they will appeal (Megerian, 12/17).

Los Angeles Times: Health Care Crisis: Not Enough Specialists For Poor
Many of the newly insured will receive Medi-Cal, the government plan for the needy as administered through the state of California. Clinics already struggle to get private specialists to see Medicaid patients because of the low payments to doctors. Last week, an appellate court decision that authorized the state to move forward with 10 percent cuts in Medi-Cal reimbursement, which could make finding doctors for those patients even more difficult (Gorman, 12/15).

The Associated Press: Providers: Medi-Cal Cuts Could Hurt Health Reform
Health providers and advocates for the poor say they are worried that California's cuts to Medi-Cal will hamper the state's ability to expand and improve health care under President Barack Obama's overhaul. A federal appeals court backed California's right to cut payments by 10 percent, saving the state more than $330 million a year. An attorney representing a group of pharmacies said they would appeal next week (Lin, 12/14).

CQ HealthBeat: Critics Say California Medicaid Cuts Upheld By Appeals Panel Bode Ill For Health Care Law
[E]ven if its impact is limited to California, it could have a big impact on [Medicaid] expansion under the health care law. "I can't speak to other states and whether this sets a precedent for them," said Molly Weedn of the California Medical Association in a brief interview. ... if the cuts take effect, the promise of health coverage for some 2.5 million to 3 million residents of the state amounts to a "false promise" because doctors won’t be able to treat them, she said. They already are being paid the lowest Medicaid rates in the nation, even before any cuts, and couldn’t keep their doors open if they accepted the state’s newly covered residents, she said (Reichard, 12/14).

Other states consider new programs to extend Medicaid coverage to some residents --

The Denver Post: New Colorado Medicaid Program Helps Middle Class With Long-Term Issues
The state of Colorado agreed, expanding Medicaid in July to allow middle-class families of children with severe, ongoing disabilities to "buy in" to the insurance traditionally for the low-income. The new benefit is being used by more than 160 children. It's being paid for with funds from the hospital provider fee created in 2009 to expand Medicaid eligibility in Colorado, and federal matching money. The state says no Colorado general funds are used for the Children's Buy-In (Booth, 12/16).

The Associated Press: NC Governor Still Working On Group Home Solutions
Gov. Beverly Perdue won't release her solution to ensure certain group home residents losing Medicaid coverage can keep a roof over their heads until probably next week. It may give her time to address another problem involving Alzheimer's disease and dementia patients. The outgoing Democratic governor said earlier this week she hoped to unveil by Friday a plan to address denied coverage for personal care services to about 2,000 residents in group homes starting Jan. 1 (Robertson, 12/14).

And many of Wisconsin's health care players sit on the fence over expanding Medicaid  --

Milwaukee Journal Sentinel: Nonprofit Health System Ducking Medicaid Issue
The nonprofit health systems in the Milwaukee area are quick to state their support for access to care and to note the costs they incur from people who don't have health insurance. But that doesn't mean they are urging Gov. Scott Walker to expand the Medicaid program under the Affordable Care Act, even with the federal government paying 100 percent of the cost through 2016, before declining to 90 percent in 2019. The governor's decision will determine whether 125,000 to 150,000 people in the state gain health insurance in 2014. So far, the five health systems that treat adults in the Milwaukee area are ducking the issue. The same holds true for community health centers, which provide primary care to many of the uninsured in Milwaukee. They, too, haven't taken a stand on whether the state should expand Medicaid to include low-income adults not eligible for coverage now. Nor has the Wisconsin Hospital Association or the Wisconsin Primary Health Care Association, which represents the state's community health centers. Only the state's largest medical societies have made their position clear (Boulton, 12/15).

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