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California gives medi-cal to undocumented migrants, paid for by the California general fund. The same program also administers federal medicaid funds for eligib

California gives medi-cal to undocumented migrants, paid for by the California general fund. The same program also administers federal medicaid funds for eligible Californians. It's a very different reality than you're trying to present.

aerostable_slug 1y ago
That's not true, and it's why clinics are panicking over the new requirement to demonstrate citizenship. The theory was Federal monies were always largely denied to undocumented migrants, but in fact there was significant admixture between state and Federal funding and clinics were reimbursed out of Federal accounts for undocumented migrant care (because California just didn't track who was a citizen and who wasn't). With that threatened there's a lot of worry here in California, especially about ERs being overrun by undocumented migrants seeking care and claiming it's an emergent issue (because where else can they go?).
- AlotOfReading 1y ago
  I wasn't aware that CA intermingled the billing. That's a big fuck-up on their part, especially if they didn't make sure the enrollment data had eligibility information.
burningChrome 1y ago
Maybe this is the reality he was trying to point out? California’s $6 Billion Band-Aid: The Cost of Covering Illegal Immigrants Last week it was announced that Governor Gavin Newsom is seeking a $3.44 billion loan from California’s general fund, as well as an immediate additional $2.8 billion in funding, to cover over-budget expenses incurred by our state’s Medi-Cal program.[1] Why is the program over budget and underfunded? There are a few factors that have gone into it, but the main reason comes down to the fact that the state expanded Medi-Cal to include coverage for illegal immigrants, and they underestimated how many of these participants would sign up to the program.[2] https://www.thecaliforniaconversation.com/articles/california-medical-crisis https://www.thecaliforniaconversation.com/articles/californi...
joshuaheard 1y ago
Medi-Cal gets 50% of its funding from Medicaid. California claims the money is separate, but since money is fungible, the federal money can be counted towards money spent on illegal aliens.
- AlotOfReading 1y ago
  It's not a fixed chunk of money going into a pot labeled "medi-cal" that gets disbursed (where fungibility would be a very reasonable argument), but literally cost sharing the services associated with the eligible enrollees in each state. Talking about the common case here, what happens is that the MCOs take money from the state to provide services based on enrollment data. The state takes the enrollment data, divides it up into "federally eligible" and "non-eligible" populations, then splits the costs of the eligible population with the federal government and pays the rest themselves. If more "non-eligible" people get services, the federal share of medicaid payments for MCOs doesn't go up. Some of the other payments like disproportionate share support the facilities themselves, which undocumented immigrants indirectly benefit from by virtue of use. That's not a significant percentage of the overall though and not what anyone is talking about.

aerostable_slug 1y ago

That's not true, and it's why clinics are panicking over the new requirement to demonstrate citizenship. The theory was Federal monies were always largely denied to undocumented migrants, but in fact there was significant admixture between state and Federal funding and clinics were reimbursed out of Federal accounts for undocumented migrant care (because California just didn't track who was a citizen and who wasn't). With that threatened there's a lot of worry here in California, especially about ERs being overrun by undocumented migrants seeking care and claiming it's an emergent issue (because where else can they go?).

AlotOfReading 1y ago
I wasn't aware that CA intermingled the billing. That's a big fuck-up on their part, especially if they didn't make sure the enrollment data had eligibility information.

burningChrome 1y ago

Maybe this is the reality he was trying to point out? California’s $6 Billion Band-Aid: The Cost of Covering Illegal Immigrants Last week it was announced that Governor Gavin Newsom is seeking a $3.44 billion loan from California’s general fund, as well as an immediate additional $2.8 billion in funding, to cover over-budget expenses incurred by our state’s Medi-Cal program.[1] Why is the program over budget and underfunded? There are a few factors that have gone into it, but the main reason comes down to the fact that the state expanded Medi-Cal to include coverage for illegal immigrants, and they underestimated how many of these participants would sign up to the program.[2] https://www.thecaliforniaconversation.com/articles/california-medical-crisis https://www.thecaliforniaconversation.com/articles/californi...

joshuaheard 1y ago

Medi-Cal gets 50% of its funding from Medicaid. California claims the money is separate, but since money is fungible, the federal money can be counted towards money spent on illegal aliens.

AlotOfReading 1y ago
It's not a fixed chunk of money going into a pot labeled "medi-cal" that gets disbursed (where fungibility would be a very reasonable argument), but literally cost sharing the services associated with the eligible enrollees in each state. Talking about the common case here, what happens is that the MCOs take money from the state to provide services based on enrollment data. The state takes the enrollment data, divides it up into "federally eligible" and "non-eligible" populations, then splits the costs of the eligible population with the federal government and pays the rest themselves. If more "non-eligible" people get services, the federal share of medicaid payments for MCOs doesn't go up. Some of the other payments like disproportionate share support the facilities themselves, which undocumented immigrants indirectly benefit from by virtue of use. That's not a significant percentage of the overall though and not what anyone is talking about.