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Medi-Cal Expansion Requires Negotiation of "Risks and Responsibilities"

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(Sacramento, CA)
Monday, January 21, 2013

People who qualify for the public health program under the Affordable Care Act will either go under an expanded state program or be under the purview of county government.

California Health and Human Services Secretary Diana Dooley says the state and the counties must still work that out.
DOOLEY: "This fundamentally changes the relationship between the state and counties for the long term."
Farrah McDaid-Ting of the California State Association of Counties says both options present challenges.
The counties are already providing health care to some of the newly eligible, but making all 58 counties responsible under the new federal health law would be a different story.
MCDAID-TING: "The challenge would be securing adequate reimbursement in an adequate time, and also complying with all the requirements and mandates of federal law."
Currently, counties spend 3 to 4 billion dollars on health care for low-income adults who don't qualify for Medi-Cal. 

McDaid-Ting says a state-based Medi-Cal expansion could take on these clients, and pose billion dollar questions for counties.

MCDAID-TING: "Do you want to keep serving that population, and keep that 3-4 billion, and take on the Medicaid expansion -, that would be the county option - or do you want to contribute some of that money to the state, for the state option."

Counties may also take responsibility for social programs such as child care as a trade-off for a state-based Medi-Cal expansion.

In either scenario says McDaid-Ting, the governments will have to make sure the new enrollees can see a provider when they need one.

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