FILE – California Governor Gavin Newsom discusses his budget proposal on Thursday, January 13, 2022 in Santa Clara, California. Newsom announced on Tuesday, January 18, that he will be offering admission to 45 California universities, including some of the state’s most prestigious campuses. The state will be part of a new public service program that will subsidize tuition for students who perform community service alongside their studies. (AP Photo/Noah Berger, File)
In January, California becomes the first state Opening the Medicaid program, known as Medi-Cal, to all illegal immigrants within our borders. Currently, approximately 700,000 adults between the ages of 26 and 49 are eligible for publicly funded health insurance.
it is 4th expansion The program for illegal immigrants was previously targeted at children in 2015, youth in 2019, and those over 50 in 2022.
No other state has gone this far. California – still. Some countries have partially extended public health guarantees to illegal immigrants. at least one – minnesota — Following California’s lead, the state plans to offer insurance to low-income undocumented immigrants in the state next year.
These efforts are based on the fundamental belief that opening up Medicaid to more people is a cost-effective way to receive quality care. That’s misguided. There are far better and cheaper ways to expand access to quality health insurance.
First, some background. Medicaid is a public health insurance plan for low-income people. It is jointly managed and funded by the state and federal governments. The federal government would provide at least $1 for every dollar each state spends on the program.
Last year, California spent $152 billion on Medi-Cal. A quarter of that amount came from the state’s general fund.
New Medi-Cal Expansion can be costly More than $2 billion is paid out each year, according to the state Legislative Analysis Service. And that may be significantly underestimated.
Over 300,000 illegal immigrants I crossed the border between Mexico and California last year. alone. If this trend continues, taxpayers who already subsidize Medi-Cal insurance for 14.6 million Californians could end up being asked to buy even more coverage.
California cannot afford the additional expense. The state is already struggling with a $38 billion budget deficit. According to the governor’s calculations.Office of State Legislative Analysis fixed the fiscal deficit At $73 billion.
But Gov. Gavin Newsom is stepping up, recently saying he is “fully committed” to expanding Medi-Cal. He may come to regret that promise. States will take on a larger share of overall Medicaid claims as coronavirus-era federal aid expires.This year’s state Medicaid spending is Expected to increase by 17%.
Adding more people to Medi-Cal not only strains state coffers, but also makes it harder for the program’s traditional beneficiaries to secure care. Already, there are not enough health care providers to care for Medicaid recipients. According to the 2021 report of the Medicaid and CHIP Payment and Access Commission. Only 70% of doctors accept new Medicaid patients. This is compared to 90% of providers who reported accepting new patients with private insurance.
The reason for this disparity is clear. Because Medicaid doesn’t pay providers enough.This program pays doctors 30% less than Medicare. And Medicare payments are 30% lower than commercial insurance.
As a result, Medicaid recipients 1.6 times less likely Compared to people with private insurance, they are 3.3 times less likely to successfully secure a primary care appointment, but 3.3 times less likely to successfully secure a specialty appointment.
If Medicaid recipients don’t have access to their regular health care provider, they’re more likely to end up in the emergency room. His 2008 study of Medicaid expansion in Oregon found that coverage was associated with: 40% increase in emergency department visits Per person – Includes visits for conditions that could have been treated by a primary care provider.
Adding millions more to the Medi-Cal rolls could make these problems even worse for all beneficiaries.
If improving access to quality care is truly what California, and all other states considering similar moves, want, there are better ways to do it.
California could start by lifting its ban on selling short-term plans. In these plans, Up to 70% cost savings than the unsubsidized option on the Obamacare exchanges.and illegal immigrants Not eligible for Obamacare Or short-term plans may be a particularly good option for receiving premium tax credits.
Private insurance options can affordably provide state residents with the care they want and need. Lawmakers in California and across the country would be wise to start expanding access to Medicaid instead of the failing Medicaid program.
Sally C. Pipes is president and CEO of the Pacific Institute and a health policy researcher. She wrote this column for her CalMatters.
