Highlights of the Newsom Administration Proposal for the Next MediCal Waiver
The Newsom Administration is preparing to ask the Trump Administration for a new Medicaid waiver. This should be interesting, as the Trump Administration wants to block grant the Medicaid program and repeal the Affordable Care Act (ACA) while California has been one of the leaders in implementing the ACA. Nevertheless California has put forward some interesting ideas that should have at least some appeal to some in the Trump Administration; we’ll see.
California’s existing waiver expires in November 2020. It included expanded behavioral health, whole person care, better dental care, expanded managed care and county health transformation into a better, more balanced, less ER and hospital based delivery system. These waiver elements should be thoroughly evaluated.
The proposed 2020-25 waiver, entitled MediCal Healthier California for All, expands managed care, expands and better integrates behavioral health, improves dental care, focuses on high risk populations, improves accountability, quality and financial incentives for better and less costly health outcomes. It reduces complexity, inter-county variability and moves Medi-Cal towards a more consistent and seamless system. It seeks to use MediCal to pay for supportive housing for the homeless. The proposal recognizes there will be no federal match available for safety care pools or designated state health programs, but continues in the right directions of quality improvements and delivery system transformation.
Prepared by: Lucien Wulsin
Dated: 1/23/20