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Dental hygienists who treat frail and elderly residents in nursing homes and other facilities are dropping out of California鈥檚 publicly funded dental program for the poor because of recent changes that cut their pay and create more administrative hurdles.
Complaints are rising in California and other states about improper evictions and discharges. Advocates say some patients end up in cheap hotels, homeless or back in the hospital.
Many medical groups and state Medicaid programs are offering gift cards, cash and other rewards to low-income patients if they agree to get preventive screenings and make healthier lifestyle choices.
State regulators and insurers are looking into SynerMed, which medical groups depend upon to handle their finances and business operations. The groups, serving 1 million patients, fear a messy fallout.
Medicaid is rarely associated with getting rich. But some insurance companies are reaping spectacular profits off the taxpayer-funded program in California, even when the state finds their patient care is subpar.
Under a five-year agreement with the federal government, California is using Medicaid dollars to expand drug treatment, including more inpatient care and a broader range of medications.
Advocates say California鈥檚 Medicaid program is violating its own rules by overturning decisions that would allow seriously ill patients to stay out of managed care and keep their doctors.
LogistiCare often shows up late, if at all, and compromises patient safety, according to a public interest firm鈥檚 lawsuit. The company says the allegations are inaccurate.
The lawsuit is a civil rights case on behalf of Latinos, who comprise nearly half of the program鈥檚 enrollees. But the advocates who filed it also hope to get class action certification for all Medi-Cal enrollees.
A forum for Asian immigrants in Oakland draws a crowd so large some attendees had to be seated in an overflow room. Many immigrants are eager for information relevant to them as changes to the health care system are debated in Washington.
A 2016 California law allowed children without papers to sign up for full Medicaid benefits. More than 189,000 children have been covered, but some families now fear renewing coverage or signing up their kids for the first time.
Some political analysts and community advocates say members of California鈥檚 Republican congressional delegation, which voted unanimously for the House bill, could be haunted at the polls.
California lawmakers consider a bill to use state money to help homeless Medi-Cal patients pay rent 鈥 shifting their focus from sheer survival to wellness. The move could save taxpayers millions, advocates say.
CEO Paul Markovich said he opposes the Republican plan because it would allow insurers to once again discriminate against people with preexisting conditions. "We are better than that," he said.
A University of Southern California professor says conservatives and liberals should split the difference: Scrap the exchanges and expand Medicaid.
鈥淚t鈥檚 challenging to see how it would not 鈥 jeopardize the entire [Medicaid] program,鈥 a top health official said.
The prospect of cutbacks has led to agitation and activism in California's largely agricultural Central Valley, with relatively high poverty rates and a significant number of Trump voters.
Lesser-known provisions in the Republican proposal to replace the Affordable Care Act would push some Medicaid enrollees out of coverage and cause financial pain for others.
California鈥檚 health insurance exchange released an analysis showing that Republicans鈥 plan to trim subsidies, on average, by 40% would fall hard on elderly and very low-income people, especially in expensive areas like San Francisco.
Under the current statute, kids are tested for lead only if they鈥檙e on certain government programs or live in older buildings. That leaves many other California children at risk, lawmaker says.
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