California gets federal approval for Medicaid waiver program

California received federal approval of its Medicaid waiver program, “Bridge to Reform.” The program is part of the state’s efforts to prepare its massive health care system for new federal requirements that will start in 2014 as a result of federal health care reform. The waiver program will give the state $10 billion in federal resources to expand health coverage to low-income, uninsured residents.

California has been in negotiations with the federal Centers for Medicaid and Medicare Services for more than a year over the waiver program. The waiver  will allow the state to pursue program changes designed to streamline service delivery and redirect any cost savings to expand care. As CivSource has reported before, the waiver is another addition to an array of programs designed to help the state prepare for upcoming health care reform requirements.

According to the terms of the final agreement the federal government will give California nearly $2 billion in Medicaid support each year for the next five years. The agreement more than doubles the current waiver investment and will allow the state to expand coverage to more uninsured adults. The state will offer this expanded coverage through its current county-based Health Care Coverage Initiative and Safety Net Care Pool.

“The approval of this waiver is critical for the people of California,” said Health and Human Services Agency Secretary Kim Belshé. “The waiver will position us to better serve low-income populations without coverage today, support our state’s health care safety net and advance needed changes in our delivery system that will help position California to successfully implement federal reform.”

Under the terms of the agreement, all counties will be able to participate in the Health Care Coverage Initiative which provides comprehensive health care to low-income adults who are ineligible for Medi-Cal. The state expects that this could impact as many as 500,000 people statewide. The waiver program will also expand the Safety Net Care pool which provides payments for uncompensated care and supports safety net hospitals. 400,000 seniors and disabled people will also gain access to improved managed care services and may be eligible for future pilot programs designed to improve care coordination and health outcomes.