Current Status of Medicaid Expansion in State:
California is expanding Medicaid, began in November 2010.
Regular legislative process.
· 30% of California’s population is enrolled in Medicaid, of who 55% have managed care. The California Medical Assistance Program (Medi-Cal) is overseen by both CMS and the California Department of Health and Human Services. Depending on the county, persons with HIV/AIDS are eligible for Medicaid programs if they are 25% to 200% FPL.
· A Medicaid expansion to 133% FPL is a 20% increase from baseline enrollment. People living with HIV/AIDS will be moved into Medi-Cal’s managed care program.
· The “Bridge to Reform” program, or the Low Income Health Program, implemented the ACA. The expansion is carried out on a county by county basis. Since the state began its expansion in November 2010 they have experienced a number of challenges and offer lessons- greater coordination and collaboration between decision-making and interested parties to avoid system dysfunction, to states ready to begin their own expansions.
· The Governor has been a vocal supporter of the ACA and led the first state expansion.
· California received a 1115 Waiver in 2010 to begin expanding Medicaid to better prepare the state for the full expansion in 2014 as required by the ACA.
· To allow California to study and find a best model, they were granted a waiver of the usual requirement that Medicaid programs must be uniformly administered statewide. California is able to try new programs and methods on a local basis and is currently operating with county-by-county implementation.
· California has held public hearings throughout the process. They also offer webinars and seek stakeholder and community member feedback. The government has made every effort to be transparent and engage the public in this process. The state website offers regular updates, reports, and video of public hearings. However, there was little or no communication with HIV/AIDS stakeholders which may result in gaps in care.
- California has partnered with OneLA, a group of churches, synagogues, and non-profits to reach out to the LA community and get more people insured, often through MediCal or Healthy Way LA, a temporary measure to cover residents until the full expansion of MediCal.
- Determining an EHB benchmark is ongoing, the state is thoroughly studying options.