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KHN senior correspondent Angela Hart discusses how California’s big Medicaid experiment to bring social services to the sickest and costliest patients doesn’t help most patients.
KHN senior correspondent Angela Hart discussed the most pressing health care issues in California with the nonpartisan group Democracy Winters in mid-November, touching on a variety of issues, from the state’s effort to transform its Medicaid program to its plan to produce generic insulin.
Centene, the largest Medicaid managed-care company in the U.S., has thrown more than $26.9 million at political campaigns across the country since 2015, especially focused on states where it is wooing Medicaid contracts and settling accusations that it overbilled taxpayers. Among its tactics: Centene is skirting contribution limits by giving to candidates through its many subsidiaries.
American Medical Response, the largest U.S. ambulance company, is ending nonemergency transportation for 12 hospitals in Los Angeles and Orange counties, saying the state doesn’t pay enough to transport low-income patients. The state is pushing back.
MLK Community Hospital in South Los Angeles is surrounded by poverty, homeless encampments, and food deserts. Even though California Gov. Gavin Newsom is funneling billions of taxpayer money into an ambitious initiative to provide some low-income patients with social services, hospital executives and other critics say it won’t improve access to basic care.
Four managed-care insurance plans may lose contracts with California’s Medicaid program, which would force nearly 2 million low-income residents to switch their health plans — and possibly their doctors. The plans are fighting back.
As California Gov. Gavin Newsom claims the role as the national Democratic Party’s political attack dog, he is trolling red-state governors over their positions on guns and abortion. He’s also making a case for himself — with health care front and center.
California Gov. Gavin Newsom signed a bill last month that authorizes a statewide Medicaid contract for HMO giant Kaiser Permanente. But details still need to be worked out in a memorandum of understanding.
As Ukrainians settle in California, many are tapping Medi-Cal. But in some counties, particularly Sacramento, the health department doesn’t have enough interpreters.
Under a budget passed by California lawmakers, the state will pay nonmedical workers who assist in pregnancy and labor up to $1,154 per birth through Medi-Cal, which is up significantly from Gov. Gavin Newsom’s initial offer of $450. Though it’s more than what most other states pay, many doulas say it falls short of the $3,600 they sought.
Covered California and Medi-Cal share a computer system for eligibility and enrollment. Nearly a decade since the Affordable Care Act expanded coverage options in the state, enrollees can be diverted to the wrong program — or dropped altogether — if erroneous information gets into the system.
California has embarked on an ambitious five-year initiative to improve the health of its sickest Medicaid patients by introducing nontraditional services. In the Inland Empire, where many residents have diabetes, one health plan is diving into the experiment by delivering healthy, prepared meals to those lucky enough to get them.
Starting May 1, low-income unauthorized immigrants over age 49 became eligible for full Medicaid health coverage, a significant milestone in California’s effort to expand coverage.
Federal funding that paid for covid testing, treatment, and vaccines for uninsured people has run out. While some states struggle to make up the difference, California is relying on other state and local programs to continue free testing.
KHN and California Healthline staff made the rounds on national and local media this week to discuss their stories. Here’s a collection of their appearances.
A controversial proposal to grant HMO giant Kaiser Permanente a no-bid statewide Medicaid contract is headed for its first legislative hearing amid vocal opposition from a coalition of counties, competing health plans, community clinics, and a national health care labor union.
Michael Hunn left the clergy and became a hospital and health system executive. He’s been named CEO of CalOptima, Orange County’s Medi-Cal health insurance plan for low-income residents, and his spiritual background is helping him guide the publicly run plan into the future.
The company awarded the state’s Medi-Cal Rx contract was taken over by another company, Centene. That left the state with a contractor it didn’t pick — one that has been accused of overbilling nine other state Medicaid programs and is now under investigation by California.
California regulators issued record fines against L.A. Care, the state’s largest Medi-Cal managed-care plan, for providing inadequate care to its enrollees. But whether the penalties are a sign that the state will make a more forceful effort to improve Medi-Cal’s overall quality of care remains to be seen.
California was supposed to start paying doulas this year to help Medicaid enrollees have healthy pregnancies. But the benefit has been delayed because doulas feel lowballed by the state’s proposed reimbursement rate, which is below what most other states pay.
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