What is Medi-Cal?
It’s a state program that provides public health insurance for low-income Californians. Its funding is shared between the federal and state government.
Many people are surprised to learn that one in three Californians – or 13 million people – have health insurance through Medi-Cal.
According to the California Health Care Foundation, Medi-Cal:
- pays for more than half of all births in California
- covers 40% of all children
- covers half of Californians with disabilities
- covers nearly 60% of all nursing home costs incurred in the state.
Medi-Cal offers hope for Californians with nowhere else to turn for health care.
A troubled program
Nevertheless, Medi-Cal is a troubled program. According to a lawsuit filed by the Mexican American Legal Defense and Educational Fund (MALDEF):
Medi-Cal patients face huge obstacles in obtaining timely access to care because the state pays providers so little for their services that many doctors decline to accept Medi-Cal patients. Those problems are further compounded by the state’s failure to adequately monitor and oversee the program, according to the lawsuit.
In fact, according to the MALDEF lawsuit, Medi-Cal ranks 48th in the nation in reimbursement rates to doctors and hospitals.
As a result, a considerable number of healthcare providers decline to treat Medi-Cal patients.
According to the California Health Care Foundation, nearly 40% of California physicians will not treat Medi-Cal patients. As a result, patients struggle to get the care they need.
What if we had Medicare for All?
You will be glad to know that under Medicare for All, this would all change!
There are two Medicare-for-All bills that were introduced this year, one in the House of Representatives (H.R. 1384) and one in the Senate (S.1804). Using these two bills as our guide, we can identify how Medicare for All would improve coverage for patients who currently depend on Medi-Cal.
#1: Level Playing Field
Medicare for All would reimburse healthcare providers equally, no matter if patients are low income, high income or in-between. That means low-income people would get the very same access to care that the wealthy would.
Medi-Cal recipients today have limited choice of doctors because the reimbursements are so low.
#2: No more health insurer interference
Medicare for All would make provider networks unnecessary, meaning patients could choose their doctors based on qualifications or location, rather than network membership.
Today, Medi-Cal patients are stuck with the very few choices their “managed care” insurance company provides.
#3: Coverage for life
Medicare for All would cover you for life, no matter how much or how little you earn.
With Medi-Cal, eligibility is constantly changing, depending on if you get a new job, lose a job or your income changes.
#4: No premiums or copays
Medicare for All would eliminate premiums and copays.
Many Medi-Cal patients today have to pay premiums and copays.
#5: No reimbursement for long-term care
Medicare for All would cover long-term care without seeking reimbursement from the estate of the deceased patient. This Medi-Cal practice is known as estate recovery.
Estate recovery can present complicated challenges for Medi-Cal recipients who own their homes.
The bottom line . . .
Medi-Cal recipients may have a lot to gain with Medicare for All, including respect. According to a 2018 California Health Report, Medi-Cal patients report poor treatment by physicians and staff.
Angelo Williams, Deputy Director of the California Black Health Network, commented:
“‘The issue is, I’ll use the [Medi-Cal] card, but I’m treated in a different way because I’m using the card,’” he recalled people saying. “The stigma is that in using the card, it reinforces some of the external stereotypes, the imposition of an inferior status.”
When everyone is covered the same way, there is a greater likelihood of being treated equally.
After all, isn’t that what America is all about?
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HEAL California is an independent news and information hub focused on the California Medicare for All movement. We feature non-partisan news, views, podcasts and videos that highlight the continuing failures of our broken healthcare system and elevate the voices of advocates and organizations fighting for change.
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