Federal Health Care Official Visits Central Valley To Discuss Medicaid Access

Seema Verma says she’s tackling the supply and demand issues tied to the Affordable Care Act expansion, with a focus on California’s Central Valley.

Verma is the administrator of the federal Centers for Medicare and Medicaid Services, having been nominated by President Donald Trump last November. She visited Modesto Monday to speak with local health providers and Republican Congressman Jeff Denham.

She wasn’t specific about pending health policy changes at the federal level, but said she would like to empower states to restructure their existing Medicare and Medicaid systems.

“As we’re putting able-bodied adults into the Medicaid program, I think the program needs to adapt to that and understand that population has different needs than somebody who’s disabled who might be on the program for their entire lives,” she said. “For the able-bodied population, it’s an opportunity for them to look at some of their holistic needs and create a program that supports them in getting independence from [Medicaid].”

California has spent the past several years enrolling newly eligible residents into Medi-Cal and into the Obama-created public health exchange, Covered California. The exchange is currently advertising open enrollment, with a focus on younger, healthier people and Latino residents.

New data from the U.S. Centers for Disease Control and Prevention shows the state’s uninsured rate at just 6.8 percent, down from 7.2 percent last year.

Verma and Denham both spoke about the lack of providers accepting Medi-Cal and Medicare in Stanislaus and San Joaquin counties due to low reimbursement rates, and the related overcrowding in emergency rooms.

“We have a very very high Medi-Cal population and very little access to care,” Denham said. ”We’re trying to make sure that as we’ve expanded care, that we actually expand access at the same time — that we’re not just giving people a card and hope, but we’re actually having doctors that are willing to see them.”

Denham and Verma met with a roundtable of local health care providers, including Gia Smith, CEO of  the American Specialty Management Group in Modesto

Smith said she was glad to have a chance to express how much residents there rely on Medicare and Medicaid, as well as her concerns about a repeal plan without an adequate replace option.

“If they can get something that provides them the great quality service and still be able to get taken care of, then that’s fine. But we have to find something that would be able to do that and keep the community going.”

When asked about solutions, Verma brought up the Center for Medicare and Medicaid Innovation, a federal demonstration project aimed at recruiting and retaining physicians in low-income counties where 35 percent of residents are enrolled in Medicaid.

She said the federal government will support states in looking for new models.

“We’re giving out waivers to a level we haven’t done in the past, and we're really looking to the states to come up with innovative ideas and then help them get there,” Verma said.