Chuck Grimes wrote:
> While Medicare is
> not means tested and is available to everyone over sixty-five who has
> contributed to Social Security,
Medicare is available to people with disabilities under age 65 who, at the time of disablement, have worked enough quarters to qualify. Also children of a disabled worker can be covered by Medicare if they are disabled.
> Another
> division in Medi-Cal is specifically for poor and disabled adults. A
> third section is an strange program for disabilities and conditions
> that arise from genetic disorders and covers both poor adults and
> children.
HMMM never heard this one before. Usually if one qualifies for SSI, the means tested program for poor disabled administered by Social Security, one automatically qualifies for Medi-Cal.
> After three years or over the age of eighteen, you can be moved off of
> Medi-Cal and turned over to Medicare as the primary, Medi-Cal as the
> secondary. This means that the state can dump cases on the Feds.
This is a very harmful game played between states and feds. The Medicaid block grants proposed by Gingrich, for instance, would have cut the federal entitlement without replacing it with any state entitlement to services. This is part and parcel of the states desire to control funds -- to get free of having to spend the money on what the feds designate it for.
>
>
> Just because Medi-Cal is a state program, doesn't mean that all
> counties in the state offer the same system. The county agencies can
> receive block grants from the state and design their own system or
> simply match the money and run the services as straight Medi-Cal. So
> this means that some counties in the Bay Area for example offer better
> and more comprehensive Medi-Cal services than others. Alameda and San
> Francisco Counties are relatively good and match the State block
> grants and extend the minimums. On the other hand San Mateo county
> (just south of San Francisco) is terrible, despite the fact it has a
> much richer local tax base. This patchwork makes moving around within
> the state a risky proposition.
This dynamic works between states as well. Some states provide fewer Medicaid benefits than others because the feds make some programs - like personal assistance services (PAS) - optional. Massachusetts probably has the best PAS program while a state like Mississippi has the worst.
This all points to the need for a universal health care plan that all states must equally adhere to.
Marta