Tag Archives: Medi-Cal

CA Gov. Newsom pushes new health care plan to help illegal aliens

Elections have con$equences.

From Fox News: Shortly after he took office on Monday, California’s Democratic Gov. Gavin Newsom unearthed an unprecedented new health care agenda for his state, aimed at offering dramatically more benefits to illegal immigrants and protecting the embattled Affordable Care Act, which a federal judge recently struck down as unconstitutional.

The sweeping proposal appeared destined to push California — already one of the nation’s most liberal states — even further to the left, as progressive Democrats there won a veto-proof supermajority in the state legislature in November and control all statewide offices.

“People’s lives, freedom, security, the water we drink, the air we breathe — they all hang in the balance,” Newsom, 51, told supporters Monday in a tent outside the state Capitol building, as he discussed his plans to address issues from homelessness to criminal justice and the environment. “The country is watching us, the world is watching us. The future depends on us, and we will seize this moment.”

Newsom unveiled his new health-care plan hours after a protester interrupted his swearing-in ceremony to protest the murder of police Cpl. Ronil Singh shortly after Christmas Day. The suspect in Singh’s killing is an illegal immigrant with several prior arrests, and Republicans have charged that so-called “sanctuary state” policies, like the ones Newsom has championed, contributed to the murder by prohibiting state police from cooperating with federal immigration officials.

As one of his first orders of business, Newsom — who also on Monday requested that the Trump administration cooperate in the state’s efforts to convert to a single-payer system, even as he bashed the White House as corrupt and immoral — declared his intent to reinstate the ObamaCare individual mandate at the state level.

The mandate forces individuals to purchase health care coverage or pay a fee that the Supreme Court described in 2012 as a “tax,” rather than a “penalty” that would have run afoul of Congress’ authority under the Commerce Clause of the Constitution. Last month, though, a federal judge in Texas ruled the individual mandate no longer was a constitutional exercise of Congress’ taxing power because Republicans had passed legislation eliminating the tax entirely — a move, the judge said, that rendered the entire health-care law unworkable.

As that ruling works its way to what analysts say will be an inevitable Supreme Court showdown, Newsom said he would reimpose it in order to subsidize state health care.

Medi-Cal, the state’s health insurance program, now will let illegal immigrants remain on the rolls until they are 26, according to Newsom’s new agenda. The previous age cutoff was 19, as The Sacramento Bee reported.

Additionally, Newsom announced he would sign an executive order dramatically expanding the state’s Department of Health Care Services authority to negotiate drug prices, in the hopes of lowering prescription drug costs.
In his inaugural remarks, Newsom hinted that he intended to abandon the relative fiscal restraint that marked the most recent tenure of his predecessor, Jerry Brown, from 2011 to 2019. Brown sometimes rebuked progressive efforts to spend big on various social programs.

“For eight years, California has built a foundation of rock,” Newsom said. “Our job now is not to rest on that foundation. It is to build our house upon it.”

Newsom added that California will not have “one house for the rich and one for the poor, or one for the native-born and one for the rest.”

In a statement, the California Immigrant Policy Center backed Newsom’s agenda.

“Making sure healthcare is affordable and accessible for every Californian, including undocumented community members whom the federal government has unjustly shut out of care, is essential to reaching that vision for our future,” the organization said. “Today’s announcement is an historic step on the road toward health justice (First time I’ve heard of “health justice.” Liberals always love to distort language.) for all.”

Read the whole story here.

DCG

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Thousands mistakenly enrolled in California's Medicaid expansion

you don't say
Shocker, not.
From CNN Money: California signed up an estimated 450,000 people under Medicaid expansion who may not have been eligible for coverage, according to a report by the U.S. Health and Human Services’ chief watchdog.
In a Feb. 21 report, the HHS’ inspector general estimated that California spent $738.2 million on 366,078 expansion beneficiaries who were ineligible. It spent an additional $416.5 million for 79,055 expansion enrollees who were “potentially” ineligible, auditors found.
Auditors said nearly 90% of the $1.15 billion in questionable payments involved federal money, while the rest came from the state’s Medicaid program, known as Medi-Cal. They examined a six-month period from Oct. 1, 2014, to March 31, 2015, when Medicaid payments of $6.2 billion were made related to 1.9 million newly eligible enrollees.
There were limitations to the California review, however. The audit extrapolated from a sample of 150 beneficiaries. The authors reported a 90% confidence level in their results — whereas 95% would be more common. That meant that the number of those ineligible could have been as low as 260,000 or as high as 630,000.
“If HHS has a strong reason to believe that California is systematically making enrollment errors, it would be helpful to show that in a more robust analysis,” said Ben Ippolito, a health care economist at the American Enterprise Institute, a conservative think tank. “The federal government should ensure that states are being good stewards of federal money.”
Nonetheless, the audit highlighted weaknesses in California’s Medicaid program, the largest in the nation with 13.4 million enrollees and an annual budget topping $100 billion, counting federal and state money. Medicaid covers one in three Californians.
The inspector general found deficiencies in the state’s computer system for verifying eligibility and discovered errors by caseworkers. The Medicaid payments cited in the report covered people in the state’s fee-for-service system, managed-care plans, drug treatment programs and those receiving mental health services.
California’s Department of Health Care Services, which runs Medi-Cal, said in a statement that it agreed with nearly all of the auditors’ recommendations and that the agency “has taken steps to address all of the findings.”
In a written response to the inspector general, California officials said several computer upgrades were made after the audit period and before publication of the report that should improve the accuracy of eligibility decisions.
Among the 150 expansion enrollees analyzed in detail, 75%, or 112, were deemed eligible for the Medicaid program in California. Auditors discovered a variety of problems with the other 38 enrollees.
During the audit period, 12 enrollees in the sample group had incomes above 138% of the federal poverty line, making them ineligible financially for public assistance, according to the report.
In other instances, beneficiaries were already enrolled in Medicare, the federal health insurance for people 65 and older or who have severe disabilities, and did not qualify for Medi-Cal. Onewoman indicated she didn’t want Medi-Cal but was enrolled anyway.
In 2014, the state struggled to clear a massive backlog of Medi-Cal applications, which reached about 900,000 at one point. Many people complained about being mistakenly rejected for coverage, or their applications were lost in the state or county computer systems.
California was one of 31 states to expand Medicaid under the 2010 Affordable Care Act. The health law established a higher federal reimbursement for these newly eligible patients, primarily low-income adults without children. After expansion started in 2014, the HHS inspector general’s office began reviewing whether states were determining eligibility correctly and spending taxpayer dollars appropriately.
Read the rest of the story here.
DCG

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Detained illegal alien who jumped off a balcony is paralyzed and now suing the government for lifetime medical care

Judge Judy shakes head rolls eyes
From Sacramento Bee: A year ago, Luis Alberto Mendez was an able-bodied immigrant from Mexico who worked as a carpenter. He had suffered from depression, but his lawyer said he had gotten the symptoms under control with medication. He was also undocumented illegal.
Today Mendez is a quadriplegic who is confined to his brother’s home in San Jose. He needs constant care and has no money. He blames Sacramento County and the U.S. government, and he’s suing them both.
Mendez, 37, is a native of Mexico who does not dispute that he was in the United States illegally in 2016. When agents detained him, he willingly signed an order agreeing to immediate deportation, his lawyer says. If the government had just sent him home then, he contends, he would not be paralyzed.
Instead, he was taken to the Rio Cosumnes Correctional Center in Elk Grove. There, his lawsuit claims, jailers ignored his pleas for access to medical care. He eventually attempted to kill himself by jumping off a second story balcony on the prison grounds, his lawyer said.
The fall didn’t kill him, but it left him a quadriplegic in need of a lifetime of medical care. His lawsuit accuses the U.S. government and Sacramento County of negligence, Fresno attorney Douglas Gordon said Friday.
“He is at a little home in the San Jose area being tended to by his family,” said Gordon, who filed the lawsuit in federal court in Sacramento on Thursday. “He’s quadriplegic; he has no money.”
The circumstances that led to Mendez being detained remain unclear.
Gordon, his lawyer, notes that federal policy at that time would have directed immigration agents to leave him alone because he had no felony convictions or criminal ties that would have led them to deport him.
Nonetheless, ICE agents set up shop outside his San Jose home in August 2016 waiting for him to appear. “They had him on some sort of list, had information on where he lived,” Gordon said. “They waited for him to come out of his house, and when he came out on his bicycle riding to work they detained him.”
Immigration and Customs Enforcement spokesman James Schwab said the agency would not comment on pending litigation.
But Gordon maintains that federal policy at the time, under the Obama administration, required that ICE agents ignore his presence in the country and focus instead on dangerous criminals or gang members.
“The worst crime that ICE has on him was a 2015 assault that was dismissed as misdemeanor,” Gordon said. “He was not supposed to be targeted.”
When Mendez was apprehended by ICE for removal on Aug. 15, 2016, the agency was working under the Morton Memo, authorized by President Obama in March 2011. That memo states that ICE’s number one priority is “aliens who pose a danger to national security or a risk to public safety.”
Immigrants convicted of crimes, particularly violent criminals, felons, repeat offenders and members of organized crime, all were singled out as priorities.
Those with mental health issues, like Mendez, were not supposed to be targeted. “Absent extraordinary circumstances or requirements of mandatory detention, field office directors should not expend detention resources on aliens who are known to be suffering from serious physical or mental illness,” the memo states.
Mendez apparently was targeted despite that edict, and appeared before a deportation officer on Aug. 15, 2016. He signed a voluntary deportation order, which typically would have resulted in him being flown home to Mexico.
Instead, for reasons that have yet to be explained, Mendez was given a notice to appear before an immigration judge in the future. He was shipped off to the Rio Cosumnes Correctional Center, where federal officials contract with the Sacramento Sheriff’s Department to hold ICE detainees.
Once there, the suit states, Mendez began asking for help for his psychiatric needs, which included access to anti-psychotic drugs to deal with a schizophrenia diagnosis, his attorney said.
Mendez had been suffering from depression before he was detained, and tried to cut himself on his neck in February 2016 and again in June 2016, Gordon said. He subsequently was prescribed anti-psychotic medications and he “was well maintained and doing fine,” Gordon said.
“Then, he was detained,” Gordon said, and authorities denied him access to such medications.
Sheriff’s Department spokesman Sgt. Shaun Hampton declined to comment on the suit Friday, saying county officials had not yet seen it.
The lawsuit says that because Mendez was denied “reasonable care,” he attempted to kill himself by jumping off “an elevated structure” and fell, hitting his head and suffering spinal cord injuries, a traumatic brain injury and other damage.
The injuries will require a lifetime of medical care, his attorney said, and his family has had difficulty caring for him.
“They’ve struggled to get him on Medi-Cal,” Gordon said. “He has nobody to care for him except his brother and sister, who work. It’s a real struggle for the family.”
DCG

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California nears letting undocumented immigrants buy healthcare

I’m betting the illegals will be signing up for health insurance, just like they rushed to purchase auto insurance (sarc).
illegal
From Sacramento Bee: Immigrants living in the country illegally would be allowed to buy health coverage on California’s insurance exchange under a bill that passed the state Assembly on Tuesday.
Already at the forefront of enacting immigrant-friendly policies, California could become the first state permitting (illegal) immigrants to use the insurance exchanges created by the new federal healthcare law. Senate Bill 10 would have California petition the federal government for the right to do so. Undocumented illegal immigrants using the exchange would not be eligible for the public subsidies that extend to other lower-income shoppers.
The measure passed 54-19, with two Republicans locked in tough re-election campaigns joining every Democrat in voting in favor. The measure now heads to the Senate for a final vote, before advancing to Gov. Jerry Brown.
Earlier in May, California began extending full benefits to undocumented children enrolled in Medi-Cal, the state’s low-income insurance program.
DCG

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Half of California's illegal aliens could qualify for Medi-Cal

No wonder illegals flock to California.
illegal
Mercury News: Half of California’s undocumented immigrants illegal aliens– about 1.4 million — have incomes low enough to qualify for full Medi-Cal benefits should California legislative proposals to offer coverage to the undocumented ever be enacted.
That is among the key findings of a Public Policy Institute of California report released Monday night which examines current policy options to provide health coverage to the state’s undocumented immigrants.
Medicaid, called Medi-Cal in this state, is a government funded healthcare program for the poor and disabled. While it is unavailable to most undocumented immigrants illegal aliens, Gov. Jerry Brown in June signed a state budget that for the first time funds the plan for an estimated 170,000 children under age 19 living in California illegally. The cost of the plan, expected to begin next year, is $40 million, rising to $132 million annually over time.

Sen. Ricardo Lara

Sen. Ricardo Lara


But Medi-Cal for undocumented illegal adults — who were included in the original legislation proposed by Sen. Ricardo Lara, D-Bell Gardens — was dropped after the state estimated the cost at more than $1 billion. Lara has said he plans to push ahead with a plan to provide comprehensive Medi-Cal benefits to those whose incomes are low enough to qualify.
The PPIC report looks at such a proposal, as well as one that would authorize the state to seek a federal waiver allowing those with higher incomes to pay full price for health plans through Covered California, the state’s health insurance exchange established under the Obamacare.
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