Sukses Main Mahjong Ways Best808 Pahami Scatter dan Kombinasinya Mahjong Ways Best808 Simbol Scatter Meningkatkan Peluang Menang Kesalahan Umum Pemain Mahjong Ways di Best808 Auto Jackpot Strategi Terbaik Fitur Scatter Mahjong Ways Best808 Mahjong Ways Best808 Panduan Scatter Wild Hasil Maksimal Pola Mahjong Ways Best808 Gacor Scatter Menang Bongkar Misteri Mahjong Ways Best808 Kunci Kemenanganmu Mau Cuan Maksimal di Mahjong Ways Best808 Trik Menggunakan Scatter Agar Lebih Untung Main Mahjong Ways di Best808 Kenali Pola Scatter Free Spin Gandakan Kemenanganmu Rahasia Scatter Mahjong Ways Best808 Strategi Jitu Menang Jackpot Besar Misteri Scatter Mahjong Ways Tol777 Kunci Jackpot Besar Bongkar Rahasia Mahjong Ways Tol777 Fitur Scatter Pola Menang Mahjong Ways Tol777 Simbol Scatter Kemenangan Besar Main Mahjong Ways di Tol777 Cara Memanfaatkan Scatter Strategi Mahjong Ways Tol777 Rahasia Scatter Trik Menang Jackpot Analisis Pola Permainan Mahjong Ways Keunggulan Mahjong Ways Tol777 vs Tradisional Kombinasi Simbol Tertinggi Mahjong Ways Langkah Meningkatkan Keahlian Mahjong Ways Mahjong Ways Tol777 Berbeda dari Permainan Mengapa Mahjong Ways Tol777 Diminati Dunia Optimalkan Putaran Mahjong Ways Tol777 Sejarah Mahjong Ways Tol777 dan Keunikan Simbol Mahjong Ways Tol777 dan Pemanfaatannya Strategi Lanjutan Mahjong Ways Tol777 Live RTP Dan Kasino Online Live RTP Dan Kasino Online Live RTP Dan Kasino Online Live RTP Dan Kasino Online Live RTP Dan Kasino Online Live RTP Dan Kasino Online Live RTP Dan Kasino Online Live RTP Dan Kasino Online Live RTP Dan Kasino Online Live RTP Dan Kasino Online Cara Cepat Kuasai Mahjong Ways Tol777 Mengapa Mahjong Ways Tol777 Populer Mitos & Fakta Mahjong Ways Tol777 Strategi Pemula vs Pro Mahjong Ways Teknik Profesional Mahjong Ways Tol777 Mahjong Ways Tol777: Keberuntungan atau Skill? Mahjong Ways Tol777: Tradisi dan Inovasi Panduan Mahjong Ways Tol777 untuk Pemula Rahasia Menang Mahjong Ways Tol777 Tips Efektif Main Mahjong Ways Tol777 Kasino Online Kasino Online Kasino Online Kasino Online Kasino Online Kasino Online Kasino Online Kasino Online Kasino Online Kasino Online main mahjong ways di malam hari jackpot profit mengamati permainan mahjong ways dengan baik dan benar merasa bosan pada malam hari? coba cara bermain mahjong ways ini minum kopi memotivasi bermain mahjong ways nelayan tebing tinggi pola mahjong ways hasil mencengangkan pelajar bandung download mahjong ways peluang besar trik dan pola mahjong ways pemuda belanda tato mahjong ways mengenang jackpot satu miliar pola rtp mahjong ways terbaik resep bermain mahjong ways dengan mudah slot mahjong ways dikenal sejak abad ke-11 hingga zaman milenial video mahjong ways viral menghebohkan warga indonesia warga jayamakmur dulu diremehkan, bermain mahjong ways hidup berlimpah harta unik keren bali cendera mata mahjong ways rp100000 warga bingung merek cat dinding sama mahjong ways RTP LIVE RTP LIVE RTP LIVE RTP LIVE RTP LIVE RTP LIVE RTP LIVE RTP LIVE RTP LIVE RTP LIVE

Despite Budget Resolution, Medi-Cal Crisis Endures

Three months late, governor Schwarzenegger has finally signed a budget. Unfortunately, the governor and legislators missed the chance to wrangle Medi-Cal, the state’s Medicaid program, under control.

The budget agreement held the line pretty well on this gargantuan program for the short term appropriating 14.5 billion for 2008-2009 versus $14.2 billion last year. But that’s not the whole story: total Medi-Cal spending will be more than twice as much, $39.4 billion, because the federal government pays the state for most of it.

But Medi-Cal’s long-term spending trend is still out of control: Between 1997-1998 and 2006-2007, MediCal spending increased at an annual rate of 7 percent, nearly doubling. And fully one third of this increase was due to increased enrollment. Because of the federal matching payments, California has an incentive to enroll more and more people into government dependency for their health care.

But Medi-Cal does no favors for providers: In 2003, Medi-Cal paid physicians only 59 percent of what Medicare (itself a poor payer) paid, on average. And the situation got worse when California started drifting into this year’s budget crisis. During the special session last February, the governor signed a bill rolling back Medi-Cal providers’ fees by 10 percent, starting July 1. Doctors and pharmacists argued that the roll-back violated federal Medicaid law, and a federal judge agreed. So, the state has partially restored the cuts imposed last summer, but continues its appeal.

The governor and legislature must be pretty confident they will prevail: The budget extends the 10 percent payment cut until March 1, 2009, after which providers will get some relief.

Or maybe not: even if the federal court decision stands, and blows up the roll-back, the state couldn’t pay providers what the judge demands anyway. In fact, the “annual” budget doesn’t really even cover the whole fiscal year. There will have to be a special election (likely next March or June) to authorize borrowing $5 billion against future lottery receipts.

So, despite years of out-of-control spending, Medi-Cal still fails both providers and patients. At its core, the problem is not a budgetary crisis: it’s a crisis of government dependency.

Nothing contained in this blog is to be construed as necessarily reflecting the views of the Pacific Research Institute or as an attempt to thwart or aid the passage of any legislation.

Scroll to Top