LONG-TERM CARE MEDI-CAL ON THE CUSP OF THE DEFICIT REDUCTION ACT AND THE AFFORDABLE CARE ACT

By Peter S. Stern, Esq.

The federal Medicaid program¹ is operated by the California Department of Health Care Services ("DHCS") as Medi-Cal. It provides services for persons of all ages: assistance for children’s health, pregnant women, women with breast and cervical cancer, home support, the aged, the blind and the disabled, and long term care coverage for persons in nursing homes or at home under waiver programs that provide nursing level services to persons living in their own homes.² This article will provide an overview of the program as it affects seniors in long term care.

First, this article will summarize the present state of the Medi-Cal long term care program, and look at changes in the program mandated by the Deficit Reduction Act of 2005 ("DRA"),³ most of which have been long postponed, as well as at changes that were to take place after adoption of the Omnibus Budget Reconciliation Act of 1993 ("OBRA").⁴

Next we look at how the long term care program has responded to the needs of registered domestic partners and same-sex couples, both before and after the demise of the Defense of Marriage Act and the rejection of Proposition 8 by the Supreme Court in 2013. Finally, this article will examine the impact of the Affordable Care Act’s Medi-Cal expansion on long term care in California.