SACRAMENTO — After weeks of wrangling, the California legislature has rejected a plan to place caps on Medi-Cal equipment and supplies expenditures that would have forced recipients to dig into empty pockets for such things as wheelchairs and enteral nutrition.
Gov. Arnold Schwarzenegger proposed the cuts as part of his revised 2010-11 budget, which attempts to plug the state's $20 billion deficit. Under the plan, Medicaid spending for durable medical equipment would cap at $1,800 annually per Medi-Cal recipient.
"The governor [put] caps on various items — $1,800 on DME, $3,600 for urological supplies, so much for wound care," said Bob Achermann, executive director of the California Association of Medical Product Suppliers. "They say it represents the 90th percentile of what the average beneficiary gets. Unfortunately, if you're out of that 90th percentile, you're out of luck. Most of the wheelchairs purchased would not be paid for entirely. It would eliminate oral enteral nutrition." There would be some exemptions for children and pregnant women, Achermann said.
Under the proposal, the majority of Medi-Cal beneficiaries would have been forced to accept whatever they could get or try to find some money to pay the balance for what they really needed. In the end, Achermann said, the caps would have saved only $3 million in a Medicaid budget of $16 billion, and the idea "met with great resistance in the legislature."
Still, the budget situation in California is so dire that the notion could resurface, Achermann said. Even though the legislature rejected the idea, "it is not to say it couldn't come back in some shape or form."
The deadline for a new budget is June 15, but the California legislature hasn't met a budget deadline in years.
"I can see a scenario where it goes until September," Achermann said.
However long budget discussions go — with the enormous unresolved shortfall and legislators scrambling to close the gap — Medi-Cal recipients won't be safe until the budget is put to bed, he said.
