Federal Medicaid Funding For Calif. Family Planning Program Reduced Over Undocumented Count

Main Category: Medicare / Medicaid / SCHIP
Also Included In: Women's Health / Gynecology;  Sexual Health / STDs
Article Date: 06 Oct 2008 - 4:00 PDT

email to a friend   printer friendly   view / write opinions   rate article

California and the federal government are in a dispute over funding for the state's Medicaid-funded family planning program -- called the Family Planning, Access Care and Treatment Program, or Family PACT -- the Los Angeles Times reports. The program offers contraceptive services, counseling, education, prenatal care and sexually transmitted infection testing to about 1.7 million low-income residents every year.

The federal government is threatening to withhold federal funding if the state does not change the way it counts undocumented immigrants who use services, and it is imposing a 5% penalty beginning today until the state agrees to new rules on how to count such patients. Under federal rules, funds only can be spent on legal residents. The federal government contributes $315 million of the program's $432 million annual cost.

State officials estimate that if the dispute is not resolved in California's favor, it could cost the state $262 million. State health officials estimate that Family PACT saves federal and state taxpayers $1.4 billion annually by helping low-income women avoid unintended pregnancies. Program officials said that as a result of the services it offers, the state does not pay for the cost of maternity care for about 170,000 women who participate.

According to the Times, the state in 1998 began using a statistical method to determine what percentage of the women who use the program's services are undocumented immigrants and should be covered by state funds. The federal government on Sept. 3 issued a letter to California officials objecting to the existing method and mandating that the program begin vetting every participant within one month.

Gov. Arnold Schwarzenegger (R) wrote to HHS secretary Mike Leavitt, saying that he is "disappointed by this abrupt action and the lack of personal consultation." HHS gave California a two-week extension to comply with the new terms of researching and documenting every participant in Family PACT before being stripped of all federal funding.

Some opponents to the federal requirement said that the cost of the program for the state could increase by 40% and that it would require 2,800 additional workers, which would almost double the staff of the state Department of Health Care Services. Officials of the program fear the new terms will scare many women away from seeking services. "We are potentially dismantling a program that everybody believes has been highly effective," Stan Rosenstein -- who runs Medi-Cal, California's Medicaid program -- said. Kathy Kneer, president of the Planned Parenthood Affiliates of California, said, "It makes no fiscal sense whatsoever. It undermines the whole cost effectiveness of the program."

Schwarzenegger and other state legislative leaders have been calling on House Speaker Nancy Pelosi (D-Calif.) to intervene. Pelosi and other members of Congress from California have written to Leavitt about the issue, but state officials said they are concerned that the dispute will not be resolved before the end of the legislative term (Rau, Los Angeles Times, 10/3).

Reprinted with kind permission from http://www.nationalpartnership.org. You can view the entire Daily Women's Health Policy Report, search the archives, or sign up for email delivery here. The Daily Women's Health Policy Report is a free service of the National Partnership for Women & Families, published by The Advisory Board Company.

© 2008 The Advisory Board Company. All rights reserved.