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February 10, 2012 > Obama administration rejects Medi-Cal co-payments

Obama administration rejects Medi-Cal co-payments

By Judy Lin, Associated Press

SACRAMENTO, Calif. (AP), Feb 06 - Federal health officials on Monday said California cannot force Medi-Cal recipients to make a co-pay for doctor visits and prescription drugs, a decision that brings relief to low-income patients but complicates the state's effort to close a $9.2 billion budget deficit.

A letter from the Centers for Medicare & Medicaid Services said agency officials were ``unable to identify the legal and policy support'' for the state's request.

The decision is the latest in a string of legal and regulatory challenges that have made it difficult for the state to reduce spending and balance its budget. Gov. Jerry Brown and lawmakers were planning to save $511 million a year in the health insurance program by requiring low-income patients to pay a share of their medical costs.

Under the state budget passed last year, Medi-Cal would require recipients to pay $5 for doctor and dental visits, $3 for preferred prescription drugs, $50 for emergency room visits and a maximum of $200 for a hospital stay. The co-pays were to start Oct. 1.

State officials said they intend to appeal to U.S. Health and Human Services Secretary Kathleen Sebelius and others in President Barack Obama's administration.

``We will be seeking a reversal of the ruling,'' said Brown's finance spokesman, H.D. Palmer. ``If this ruling were to stand, it's another instance where the state would be precluded from achieving savings the Legislature has approved.''

Advocates for the poor called it the right decision, saying the co-pays would have deterred people from seeking preventive treatments.

``For a lot of folks, hearing $5 for a doctor visit or $3 for a prescription doesn't sound like a whole lot, but when you're talking about a person on Social Security who relies on five prescriptions and regular doctor visits or when you are talking about somebody living on $500 or $800 a month, that's a large percentage of their budget,'' said Vanessa Cajina, a legislative advocate for the Western Center on Law and Poverty.

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