Center for Health Policy Research addresses CA state audit of Medicaid program

Dr. Gerald Kominski, director of the UCLA Center for Health Policy Research and professor of FSPH health policy and management was quoted in a June 22 NPR article about the failure of Medicare to serve the large number of enrollees and their complex needs.

Monday, June 22, 2015


Terri Anderson signed up for California's Medicaid program earlier this year, hoping she'd finally get treatment for her high blood pressure. But the insurer operating her Medicaid plan assigned the 57-year-old to a doctor across town from her Riverside, Calif., home and she couldn't get there.

"It was just too far away," says Anderson, adding that she cares for her 90-year-old ill father and can't leave him alone to make an hour round-trip drive to the doctor. Now she's crossing her fingers that a health clinic near her house will accept her new insurance.

She's not alone. In an effort to control costs in its rapidly expanding Medi-Cal program, California has relied heavily on managed care insurance companies to treat patients like Anderson.

The state pays insurers a fixed amount per enrollee and expects the companies to provide access to doctors and comprehensive care. But a scathing state auditreleased last Tuesday shows that California is failing to make sure those plans deliver. Many enrollees have insurance cards but often have trouble getting in to see a doctor.

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