Since passage of the Affordable Care Act (ACA) in 2010, California has been touted as a leader and pace-setter with respect to implementation of the law. Not only are Californians already benefiting significantly from the ACA – for example, the ban on coverage denials due to pre-existing conditions for nearly 600,000 children and the over 350,000 young adults who are able to stay on their parents’ health plan – but Californians stand to benefit even more from a federally-funded Medicaid coverage expansion that could begin in 2014.
The federal health law, reaffirmed by a landmark Supreme Court ruling in June 2012, offers states like California the opportunity to expand their Medicaid eligibility levels to cover all low-income populations below 138% of the federal poverty level beginning in 2014. The federal government will pick up the entire cost of covering the newly-eligible populations, namely parents and adults without dependent children, from 2014 to 2016 and will continue to cover 90% of the cost after that.
Given the precedent that has been set, one might anticipate that California would continue to lead the nation in ACA implementation; however, Governor Jerry Brown and state health officials have yet to affirmatively take up the full expansion of Medicaid, called Medi-Cal in California. Last month Nevada’s Republican Governor Sandoval publicly endorsed an expansion of Medicaid in his state, and Governor Brown would be wise to do the same when he unveils his budget proposal next week.
The expansion of Medi-Cal is an opportunity that California cannot afford to miss. Not only could it help reduce the number of uninsured Californians by nearly 40%, but it is also fiscally shortsighted to leave billions of dollars in federal funds on the table that could be used to help pay for health care that today often goes uncompensated, putting an unnecessary strain on providers and the system as a whole.
California children’s health advocates, among many others, agree that continued implementation of the ACA by expanding Medi-Cal is without a doubt the right thing to do for California’s families and the future of health care in this state.
The health of parents can have a dramatic effect on the health and well-being of children. In fact, research shows that providing coverage for low-income parents and other family members is good for children too – in part because expanding Medi-Cal coverage to more low-income parents means that many of the 700,000 uninsured children in California who are eligible for coverage but not yet enrolled will get enrolled in health coverage when their parents sign up.
Successful implementation of health reform in California will ultimately depend on creating a “culture of coverage” and connecting as many Californians with health coverage as possible. California’s families – and the entire state – will benefit if California fully implements the Affordable Care Act including the Medicaid expansion.
Governor Brown and the Legislature should move forward without delay to make this sensible and cost-effective decision.
- By members of the California Children’s Health Coverage Coalition: California Coverage & Health Initiatives, Children Now, Children’s Defense Fund – California, The Children’s Partnership, and United Ways of California