The unfortunate facts are what they are: California’s fiscal hardships are just as bad as you thought, possibly worse. According to a new report released this week, the cost of Medi-Cal in particular has put a real strain on California’s budget.

From coverage of the report this week:

Tops on the list of concerns in the report is the high cost of Medicaid, the federal program providing health care for the poor or disabled and administered here in California via the state program Medi-Cal. Funding for the health care services, and rules about eligibility and spending, are shared between states and the feds.

“The rapid growth in Medicaid spending has pushed aside other types of state spending,” says the report.  “Both the states and the federal government need to find ways to contain and control Medicaid costs.”

Regarding Medi-Cal, the question remains what will happen to the program–and how it will impact the budge–under the new Affordable Care Act, which a Daily News report indicates will provide health care (in part through Medi-Cal) to over 2 million residents in Los Angeles alone.

One pharmacist argues this week that the ACA will provide more competition to insurance companies, which could benefit health care providers and provide incentives for offering better care–competition could mean higher reimbursements.

From the article:

As a local pharmacy owner, […]the cash price of prescription drugs is not “stunningly less” than the insurance price. Insurance companies have been squeezing reimbursements to ALL healthcare providers (including pharmacies) over many years now, and have funneled money away from providers (who take care of patients) in order to boost corporate profits. […] those who have health insurance are ALREADY paying for the uninsured through the outrageous and ever increasing premiums that we pay. Being a business owner who provides generous benefits to my employees, I can attest to this fact first-hand. And the insurance companies, unchecked by real competition (that a government supported exchange would otherwise provide) keep raising their premiums at will.

With state budgets in bad shape, many legislatures are turning to cutting state programs in desperate attempt to stem the tide of deficits. Among these plans is the move to shift Medicaid patients to a managed care program, which is happening in states such as Texas and Florida. Many see this as a way to save millions of dollars for state budgets, but this plan will only cost more in the long run.

According to a report from Bloomberg (emphasis ours):

Bloomberg Government health-care policy analyst Christopher Flavelle looked at managed-care plans in the five most populous states, including New York and California. His Bloomberg Government Study found large managed-care plans provided health care that was significantly and consistently worse than the national median.

For patients, the outcome may mean poorer health care. For states, the outcome may be higher costs when patients return to the system with more serious conditions.

Some states are starting to penalize the private managed-care providers because they perform poorly. The managed-care providers face the choice of doing a better job, or betting that states will continue to tolerate poor results.

This is not the first evidence that managed care systems are not a good solution for Medicaid, nor will it be the last. The only question remaining is whether states will listen, and take steps to course correct.

Managed care is bad for patients, and is also bad news for health care providers such as hospitals, doctors, and pharmacies. Many pharmacies under managed care will be forced to make the choice between remaining open and barely turning a profit, turning away longtime Medicaid patients they can no longer afford to service, or shutting their doors altogether. This is unacceptable.

Join Pharmacy Choice and Access Now, and fight back against managed care for Medicaid!

California is in the midst of another budget crisis, and Governor Brown is looking to take $1.8 billion from the state’s Medicaid program, known as Medi-Cal, to help make up the shortfall. As part of the cuts to the Medi-Cal program, the governor’s plan includes cutting funding for hospitals and nursing homes. For many members of California’s most vulnerable and frail populations, this will mean more cuts to health care services that they rely on and loss of access to life-saving medications.

According to a local news report:

For many of those who rely on Medi-Cal to live as normal a life as possible, the proposed cuts will have major consequences.  Eva Crump turns 86 next month and says it’s scary for her to think about more cuts to her Medi-Cal benefits… A diabetic with a recently diagnosed heart condition, Crump relies on Medi-Cal to get the medicine she needs to live an independent life. “There are so many of us that need these facilities to get out and be taken care of without having to go into a bed and care home or something of that type”, Crump says, “its just like a God-send to have it available.”

Medicaid cuts at the state level are hurting seniors nationwide, with many of these types of budget cuts resulting in loss of access to some of their most vital health care services. In additional to hospitals, nursing homes, and senior care centers feeling the impact of state budget slashes, community pharmacies are often forced into an impossible predicament when reimbursement rates are lowered. Do they turn away valued and loyal customers, many of whom rely on their pharmacist as one of their primary health care providers? Or do they shut their doors, unable to stay in business and still service their Medicaid-dependent clientele?

One thing is clear: in situations like the one in California, there are no winners. Medi-Cal recipients like Eva Crump are hurting, health care providers are hurting, and community pharmacies are hurting. Surely there are other ways to solve a state’s budget woes than to cut access to vital services for the most vulnerable populations?

To find out more about Medicaid cuts and how they will impact seniors, community pharmacy access, and more, visit Pharmacy Choice and Access Now.