History
Issues
of San Francisco
Medi-Cal and Medicaid Issues
What
are Medi-Cal and Medicaid?
Medicaid (Medi-Cal in California) is nation's largest single insurance
plan, covering 47 million. It is primarily a program for the poor, covering
12 million poor elderly and disabled adults, one in five children, poor
pregnant women, 60% of the elderly in nursing homes, and disabled adults.
It provides basic hospitalization, doctor's visits, prescriptions, long-term
care, tests, and many other services. Because of funding cuts, Medicaid
services have been compromised for years, but the intent of the program
has continued.
Currently, Medicaid is run by states in accordance with federal guidelines,
and is financed by Federal-State cost-sharing, where each state dollar
is matched by one to three federal dollars, without limit.
As healthcare provider for the poor, Medicaid is the second most costly
item in states' budgets, and costs are increasing because of growing unemployment,
loss of job-based health insurance, the high-cost of job-based to workers,
low wages, and 43 million uninsured. At the same time, state budgets are
still suffering their worst deficits in 50 years, because of collapse
of the dot-com bubble, tax cuts to the rich, and decreasing federal revenue
because of the expenses of war and homeland security. Because of these
factors, the federal government and virtually all states and federal governments
are agressively cutting Medicaid/Medi-Cal expenses and services.
Many of the states' strategies to cut Medicaid expenses involve getting
waivers, permissions from the federal government allowing states to operate
their Medicaid programs free from various federal regulations.
Medicaid waivers are generally gotten to save states money, though some
waivers allow states the flexibility to have more state services qualify
for federal assistance. However, waivers must be "revenue neutral"
(not cost the federal government more than without the waiver), so that
added services often come at the expense of other services.
Summary
of States' Cuts in Medicaid Programs (Microsoft Word Program)
State
and Federal Moves to Cut Costs and Services
by Restructuring Medi-Cal and Medicaid
California's plan to introduced Tiered Medi-Cal
The Federal plan to introduce Block Grants
into Medicaid
Protest Schwarzenegger's
Dirty Deal to Cut Federal Medi-Cal Funding for the Next Five Years!
The Deal: the State gives the Feds permission to cut funding & The
Feds give the State permission to cut Medi-Cal services. Learn the impact
on San Francisco Public Health, which is already struggling. See Factsheet.
Useful Links
Resources
for people on Medi-Cal or who want Medi-Cal
Medi-Cal
101, Comprehensive Facts and Figures on Medi-Cal from the California HealthCare
Foundation (53 pages, slow download)