Thursday, July 30, 2015

1 in 3 Californians Enrolled in Medicaid

This is from James Poulos writing at Cal Watchdog:
The Golden State has seen more than triple the expected enrollment under the Obamacare-authorized expansion of Medicaid, a surge of over 2 million. “Beyond that,” the Associated Press reported, “a record number of people who already qualified for the low-income health program signed up, pushing overall enrollment in the state’s Medicaid program known as Medi-Cal past 12 million to roughly 1 in 3 Californians.” ... 
While legislators have crunched the numbers, regulators have labored to understand just how poorly the new health care regime matches up with the demand it has created. In an effort to control costs, California “has relied heavily on managed care insurance companies,” the San Francisco Chronicle noted in a report on the state’s struggles to come with Medi-Cal demand. Under the current approach, California “pays insurers a fixed amount per patient and expects the companies to provide access to doctors and comprehensive care, rather than paying for each medical visit or procedure under a fee-for-service model.” 
Trouble has arisen around what happens next. Last month’s state audit of the managed care system revealed that many of those enrolled in an insurance plan effectively can’t get to a doctor. “The California audit found the state didn’t verify that insurers’ directories of doctors were accurate, or that the plans had enough doctors to meet patients’ medical needs,” the Chronicle confirmed. “And thousands of phone calls to an ombudsman’s office — created to investigate complaints — went unanswered every month.” ...