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ACA Fail Fractal
Access Problems for California Medicaid?

Since the passage of the ACA, California’s Medicaid program, called Medi-Cal, has seen 3.5 million new first-time users, and almost one-third of state residents are covered through that program. But not all is well for those enrolled in Medi-Cal. The LA Times reports on a new audit that highlights how poor state records have made it difficult for enrollees to reach doctors:

Auditors analyzed the provider directories of three plans — Anthem Blue Cross in Fresno County, Partnership HealthPlan of California in Solano County and Health Net in Los Angeles County — and found that they contained inaccurate information for 3% to 23% of providers.

The state is required to certify that health plan networks offer enough doctors, and that patients don’t have to drive too far to get care. But the audit found the state couldn’t be certain the plans were meeting patients’ needs, because the Department of Healthcare Services wasn’t verifying the data that plans submitted to the state.

For instance, although the department had not found “any inaccuracies in the three provider directories,” auditors said they discovered wrong telephone numbers and listings for doctors who were no longer in the programs.

In one way, this might seem like a relatively superficial problem. The state just has poor records and should correct those—wrongly listed telephone numbers do not tell any kind story about a structural issue with Medicaid. But at another level, the problem might be more serious, because the audit may have turned up not only incorrect phone numbers for doctors but also listed doctors who aren’t “in the programs”—i.e. who aren’t offering health care to Medicaid patients. And earlier in the story, the LA Times also cites a case of a state resident finding that some of the doctors on the state list were no longer accepting new patients.

In other words, there are at least some signs that Medi-Cal’s difficulties are not just a matter of clerical errors, but also something worse: there may be serious access problems for Californians on Medicaid. That possibility illustrates the fact that it’s never enough when evaluating health care reforms to look at how many more people are “covered.” The more important questions are how much and what type of care that official coverage gets someone, and whether our system is affordable and efficient enough that those covered in it can have a reasonably good health care experience.

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  • Dale Fayda

    A third of the county’s most populous state is on Medi-Cal, i.e. welfare.

    Ain’t liberalism grand?

  • Andrew Allison

    Amazing is it not that, greatly increasing the demand for health care while reducing the supply by way of inadequate compensation is a problem [sarc]. If you think the present situation is bad, consider the recent decision by the inmates running the California asylum to permit undocumented residents to enroll in ACA.

    • fastrackn1

      Well, illegals can get a mortgage called an ITIN mortgage, so why not ACA?

      Why bother to ever be legal?

      Heck, why have a border at all?….

      • Andrew Allison

        Well yes, if you become legal you might have to make some small contribution toward the benefits you and your undocumented cohorts receive. But in all fairness, it’s more complicated than that. The economy of what would be the sixth or seventh nation (not to mention the grocery bills of the entire USA) is in large measure dependent on illegals. A rational approach (not to be found in Sacramento) would be to acknowledge this and pay the price. This could be done in two ways: stop the nod, nod, wink, wink so-called immigration policy of token roundups and deportations, or some sort of amnesty. I have a problem in principle with the latter (if you came illegally you broke the law), but recognize the benefits which California and the nation as a whole derive.

        • fastrackn1

          You are right, it has always been winks and nods regarding illegals here. But that is fine because the illegals get what they want (more opportunity and better wages than in their country), and we get lower priced goods, mainly food. The problem is that illegal immigration has for some reason gotten out of control in the last about 20 years. Now they have taken over the construction industry, landscaping, dish washing, and many other manual labor jobs, not because Americans didn’t want to do them, but because Americans didn’t want to do them for as cheap as an illegal would. So now many Americans are out of a job because of it. If we were to send most of them back so that there were just enough to cover the agricultural jobs as there used to be, more Americans would have a job. Yes wages would rise in those jobs, but Americans have always done them at a fair American wage so the economy would adjust as it had before the huge influx of illegals came.
          The problem with amnesty or guest worker solutions is that wages would go up for illegals because they would no longer be illegal. So they would have many American jobs and at higher wages. Those jobs at the higher wages should be reserved for Americans.
          Outside of agricultural workers, I don’t see any real benefit to the illegals here. Yes they work for less, but Americans have always done those jobs and our economy was better back then than it is now. The great benefits that we hear about from the cheap labor is just nonsense uttered by the left who wants to expand their voting base with more minorities, and on the right by the business community who just want to line their pockets.

          • Andrew Allison

            Yup!

        • Dale Fayda

          Benefits? Hardly.

          I live in So. Cal and the illegals are a plague here and elsewhere in the state. Prisons here are FULL of them, since they’re mostly illiterate dregs of Mexico and Central America. Formerly solid middle-class towns all over the state are now gang infested, poverty ridden, bankrupt Third World hell holes – Sacramento, Bakersfield, San Bernardino, Modesto, Oxnard, Santa Paula, the entire Central Valley and on and on and on.

          Drugs, depravity, sloth, exotic diseases, ruined neighborhoods, atrocious public schools, overburdened and failing welfare services – these are the “benefits” brought upon us by the illegal invaders.

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