MEDI-CAL BENEFITS ELIMINATION-

The time has come for adults with Medi-Cal to say goodbye to a handful of benefits.
These benefits involve services that used to be available to adults, most specifically dental coverage.

Many Californians with Medi-Cal are already being denied service because doctors can’t afford to treat patients when the patients’ insurance only covers a fraction of the costs.

Elimination of these specific benefits will save $134 million in 2008 and 2009. The federal government considers these benefits which include: acupuncture, audiology, optometry, podiatry, speech therapy and psychology “optional”. The legislature’s fiscal adviser recommended that lawmakers approve this.

Last year the health care budget was only cut only $10 million in Medi-Cal benefits, miniscule compared to the cuts this year.

Medi-Cal is the second-biggest expenditure in California following education. It is funded by the state and federal government and is projected to cost $38 billion next year. $15 billion will come from the state’s general fund.

These benefits include incontinence creams and washes, acupuncture, dental, audiology, optometry, optical, chiropractic, podiatry, psychology and speech therapy.

The Health Access Analysis of the 2008 and 2009 Health Services Budget reveals that adult dental benefits will account for the largest portion of the cuts by accounting for almost $115 billion dollars

Since Medi-Cal serves the poorest Californians, three million low-income adults, some with disabilities, will lose dental coverage.

Maria Oregel a resident of Yolo County will be one of the many residents who will be effected with this budget cut. “That is wrong what their doing, the government should give the opportunity those who are less fortunate and don’t have insurance instead of taking away,” said Oregel.

While the state will about $115 million from the cuts of dental benefits they will also loose an equal amount in matching federal dollars.


The lack of dental treatment will likely result in higher medical and hospital costs since people will have to have dental procedures preformed at the at the emergency rooms in hospitals.

The budget cuts that will effect chiropractic care, acupuncture, audiology, optometry, , podiatry, speech therapy and psychology will save a combined $19 million

Adults on Medi-Cal who are having their benefits eliminated will have a difficult time finding doctors that will take them on as patients. Manuel Ochoa 85 has had Medi-Cal for over 40 years and doesn’t understand how the budget works. “ I don’t care I just need to be treated, I’m old I could die and I would not understand how the system works,” said Ochoa.

Senators have voted to reduce Medi-Cal payments to doctors by 10 percent , cutting about $577 million total from the Medi-Cal program.

Senator Dennis Hollingsworth, the former Vice Chairman of the Senate Budget Committee for over three years, supported the cuts.

“Senator Hollingsworth voted for these cuts because he realizes that the state budget is in a terrible predicament and we needed to find ways to bring the state back to fiscal solvency,” a spokesman for Hollingsworth said.

Governor Schwarzenegger called for the state budget to cut 10 percent across the board because the state is facing a $16 billion deficit.

“Senator Hollingsworth realized we needed to bring the deficit back down consistent to the revenue the state is bringing in,” the spokesman said. “Health issues aren’t something he focuses on.”

Some healthcare advocates say these cuts will make it challenging for caregivers to afford to stay with the program.

“There is no benefit to going without health coverage. Patients will delay care and get sicker,” Health Care Policy Coordinator Hanh Kim Quach said.
Quach works for Health Access California, a statewide non-profit organization founded in 1987, dedicated to achieving quality, affordable health care for all Californians.

Health Access has advocated for healthcare reform to provide immediate healthcare services to California’s most valuable populations.
“We do research, advocacy and lobbying to prevent the cuts. We keep advocates around the state informed about actions so that they may act to prevent the cuts,” Quach said.

Approximately seven million people depend on Medi-Cal for health care purposes and about six million of them will be directly affected by these cuts.

Families will see in increase in co-payment, a family of three, for example, who makes over $26,400 a year would see an increase in co-payments from $5.00 to $7.50. People with Medi-Cal will receive less services for more money.

Bertha Torres, a Woodland resident disagrees to having to pay co-payments. She doesn’t receive any Medi-Cal but her family does. Her niece is single and has two girls. One of the girls just turned 18 years old, she has medical problems that her Medi-Cal coverage can not cover because some benefits like speech therapy for example will be removed. .

“They will not get the care they need and get sicker as a result. That will cost the entire system money as sicker patients are more expensive to treat,” Quach said.

The assembly bill ABX1 was defeated in the Senate Health Committee in January because a “highly respected advisor to the Legislature” worried that the average premium cost would be too much.

The bill’s projected cost would be $250 per member each month but projections can underestimate costs in the long term.

Rejection of the bill came from the fear that the average premium may end up closer to $300 per member each month because of inflation and difficulty projecting rate in the future.

In the potential situation that the premiums became that expensive the purchasing pool would then have a budget deficit more than $4 billion by 2015.

One average Medi-Cal member accounts for $187 per month and the author’s of ABX1 came up with the $250 projection because they added a 30 percent margin.
This bill was one of the efforts of healthcare reform that failed because of the costly expenditures that the current system had with the new cuts.

Sandra Shewry, director of the state Department of Health Care Services told the L.A. Times in March that earlier this year lawmakers rejected Schwarzenegger’s proposal for universal healthcare.
The proposal would have included a raise in rates paid to Medi-Cal doctors and the payments would have been funded by billions of dollars in new fees.

Pharmacist Ira Freeman is not directly affected by the budget cuts because pharmaceuticals aren’t part of the benefits that have been victimized.
He is outraged and is fasting for 15 days in protest, according to an article in Drug Week.

Ted Mazer is an ear, nose and throat physician in San Diego who recently received a check for $168 from the California’s medical insurance program.
The problem is that the check was for a tonsillectomy, a procedure that costs far more than what the check covers and Mazer had to cover the balance with his own money.

He has since joined the trend of many physicians by no longer accepting patients with Medi-Cal.

Throughout California people with Medi-Cal will continue to have problems finding doctors within reasonable locations that will treat them.