Medi-Cal, Other Government Healthcare Programs Struggle to Keep their Promises
In its recent decision in King v. Burwell, the Supreme Court upheld an interpretation of the Affordable Care Act (ACA), permitting the distribution of subsidies through federal exchanges. This is not the first time that the ACA – colloquially known as Obamacare – has been challenged in the Courts, and unless the President works to fix the problems with this healthcare system, more issues may be expected to come. Back in 2010, the President and his allies pushed this overcomplicated and mistake-ridden law through Congress, and as time goes on, the law’s many flaws are becoming increasingly apparent. Americans want to access quality care at competitive prices, but as we have seen, bigger government healthcare programs do not necessarily lead to better outcomes, especially within the Hispanic community.
Look at the example of California, a state known for not only their large Hispanic population, but also for their multitude of costly big-government programs. Recently, the California state auditor released a scathing report on the efficacy of Medi-Cal, California’s Medicaid program. This year alone, California health officials failed to ensure access to doctors for over 9 million residents who used Medi-Cal’s managed care plans. The report went on to note that this problem might have been addressed earlier, but residents were not provided any opportunity to make their complaints heard. When California residents tried to call Medi-Cal’s local ombudsmen – the officials appointed to investigate individual complaints against poor program administration – to get help accessing their medical care, they simply got no response. Medi-Cal’s ombudsmen ignored an average of 12,500 calls every month for nearly a year, and even when calls got through the system, staffers were only able to answer 1/3 of them because of frequent system crashes. A third of California’s residents and half of California’s children were depending on care from Medi-Cal, but the inability to effectively oversee this giant government program prevented the state from fully following through on its promise.
This auditor report is not the first time that Medi-Cal has come under heavy criticism for its problems effectively communicating and working with local county governments. In the early days of Medi-Cal, many people became newly eligible and applied for coverage, but unfortunately the small county offices were not able to efficiently process all the applications coming from the big government program. Last summer, administrative delays and computer issues caused an enormous backlog of over 900,000 applications, with residents seeing their coverage delayed for months, instead of the promised 45 days. These administrative failings left many Californians waiting for the care they were promised, and came at a high cost for many families.
Unfortunately, these types of flawed execution issues are all too common in government-controlled health care systems. Obamacare puts the federal government at the center of our personal health care, with government bureaucrats making decisions that should be made by individual patients and their doctors. Under the ACA, California’s big-government health insurance solution is functioning very poorly – so poorly, in fact, that many Latinos living near the U.S.-Mexico border are deciding to cross the border to get their primary care in Mexico, even when they have their Medi-Cal cards. Border-state Latinos have figured out that they receive a better quality of care, get more attention from doctors, and pay less for visits in Mexico than they do in the United States under the government insurance program. American residents should not have to go to another country to receive quality care, but the higher cost, higher deductibles, and lack of available doctors under Obamacare unfortunately leave this as their best possible option.
Another regulatory political band aid is not going to fix this fundamentally flawed law. However, there are solutions to this problem, and the King v. Burwell decision provides an opportunity for both Republicans and Democrats to work together with the President and with the state governments to find free-market oriented and innovative solutions that help patients receive the care that they so desperately seek, at a more affordable price.