CIRS Blog about Rural California
By Ron Shinkman
After nearly a decade of cuts and incomplete coverage, Californians enrolled in the state’s low-income dental program have full coverage this year.
But whether there will actually be enough dentists willing to accept the low-reimbursement rates and red tape often attached to the Denti-Cal program remains to be seen.
Denti-Cal provides dental services to roughly 14 million children and adults statewide. But coverage for the 7 million adults enrolled was hobbled for years following the 2007 economic recession.
“All five children get lunch at school,” mother Maria Chavez said through a Spanish interpreter. School lunches help the Chavez’, whose names have been changed, make ends meet.
Arturo Chavez, 7, is my clinic patient in South Los Angeles. He has developmental issues, notably a speech delay. But with help from medication and therapy, he is catching up to his first-grade peers. He is an engaging little boy who loves to tell stories, even with his speech difficulties.
Arturo has four siblings, ages 4 to 17, and all are in school. Maria Chavez, their mother, is unable to work, in part because of Arturo’s frequent appointments. The children’s father’s monthly income as a restaurant cook is less than $4,000.
“At the end of the month, it’s difficult,” Maria Chavez said. “So we go to food banks or our church for food.”
By Lynn Graebner
Counties all over California are cheering the state’s decision to expand Medi-Cal to more than 1.4 million low-income adults – and bracing for the $1.3 billion the state expects to take away from county health services over the next four years.
Counties should see savings on January 1, 2014, when Medi-Cal expands to include childless adults under the age of 65 with incomes less than 138 percent of the federal poverty level or $15,856 for an individual annually. The federal government will pay 100 percent of the costs for new enrollees from 2014-2016 and 90 percent in 2020 and beyond.
“On paper, you’d think there would be savings,” said David Luchini, Assistant Director of the Fresno County Department of Public Health. But the UCLA Center for Health Policy Research predicted in a Sept. 12, 2012 report that three to four million Californians would remain uninsured in 2019. Counties say it is way too early to count on savings from the ACA and to chop away at county health care safety nets.