Policy Pick: Massive Fee Increases Proposed to Children’s Health Programs for Low-Income Families

Nearly $1.5 billion in cuts to Medi-Cal, which provides health insurance coverage to nearly eight million California residents, were approved on Feb. 15, according to Health Access. The changes include an increase in co-payments to $5 for doctor and dental visits and prescriptions, $50 for emergency room visits and $100 a day for hospital stays (up to a maximum of $200). The Committee also voted to decrease the reimbursement rate for Medi-Cal providers by 10 percent and eliminated Medi-Cal coverage for over-the-counter drugs, like cough syrup.

The Committee also voted for increases for participants in the Healthy Families program, California's version of the federal State Children's Health Insurance Program (SCHIP). Healthy Families covers approximately one million children whose parents' incomes are too high for Medi-Cal, but who are between 200 and 250 percent of the federal poverty line. The changes include:

• An increase of 75 percent in per-child premium to $18. The maximum per family is $126.

• Increase in emergency room co-payments from $15 to $50.

• A raise in hospital inpatient services co-payments to $100 per day (up to a $200 maximum).

The Committee did reject Gov. Jerry Brown's proposed $11 million cut to vision coverage for Healthy Families beneficiaries. The chairman of the Senate budget committee, Sen. Mark Leno (D-San Francisco), recalled his own experience as a fourth grade student whose vision improved after visiting an eye doctor and receiving glasses. The democratic majority did, however, accept a $3 million cut to the vision coverage benefit. These cuts will be achieved by restricting the types of glasses and lenses available to children through Healthy Families and limiting the reimbursement rates to providers.

These cuts and fee increases come at a particularly difficult time for low-income children and their families as state budget cuts threaten numerous services. For example, Brown proposed $1.5 billion in cuts to CalWORKs by limiting benefits to 48 months of cumulative cash assistance and cutting grant amounts by 13 percent. The cuts in CalWORKs would exponentially increase the effects of the cuts in Medi-Cal and Healthy Families and the overall impact felt by low income families.

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