GOVERNOR WORKING WITH MEDI-CAL PROVIDERS.

Byline: David M. Drucker Sacramento Bureau

SACRAMENTO - Gov. Arnold Schwarzenegger is trying to blunt opposition to his plan to cut taxpayer-subsidized health care by reaching a deal with those who would be affected.

Similar to the way the Republican governor approached the education lobby - and successfully negotiated $2 billion in public school cuts that now require legislative approval - he is working with groups representing Medi-Cal providers and recipients on a reform package, with the goal of submitting it to the Legislature in late May for approval in July.

``I think it's helpful that they come to us if they're really seeking our input and this isn't window dressing,'' said Edmund Carolan, assistant director of government programs for the California Primary Care Association that represents community medical clinics.

``My fear is they've already made up their mind,'' he said, ``and they can say, we met with you.''

Administration officials say that reaching a consensus on reforms to slash Medi-Cal costs appears nearly impossible because of the large number of competing interest groups. Add to that the ambitious timeline established by Schwarzenegger, requiring a likely hostile Legislature to approve his package no later than July, and the administration is bracing for an uphill battle.

``I think it's going to be a very difficult process; no question about it,'' Health and Human Services Secretary Kim Belshe said. ``You can't do anything without making a particular constituency grumpy.''

Two stakeholder meetings, in late January and early February, were each attended by more than 300 people and present a stark contrast to negotiations with the education community that netted a temporary reduction in public school funding. Those talks involved primarily one group - the California Teachers Association - with whom the governor had an existing relationship.

Complicating matters, Medi-Cal interest groups not only oppose Schwarzenegger's ``reform'' goals of lowering the amount of eligible Medi-Cal recipients and number of services offered without a co-payment, they are also critical of the spending cuts and enrollment limits he wants to implement in 2004-05.

``We would be glad to sit down with them to discuss changes in the Medi- Cal system,'' California Medical Association spokesman Peter Warren said. ``But we can't start with savings on the back of children, the elderly and the disabled that Medi-Cal is there to help.''

According to a timeline called ``ambitious'' by Belshe, Schwarzenegger plans in May to propose specific reforms to the Democrat-controlled Legislature, incorporating the input of Medi-Cal interest groups, with legislative approval targeted for July.

If the cost-cutting reforms are passed by the Legislature, state officials would ask Washington for the federal OK needed to implement the reforms.

Medi-Cal is California's version of the federally mandated Medicare health insurance system, so Washington would need to approve the reforms - or ``waiver'' request. The governor hopes this will happen by December so actual implementation can begin in July 2005.

David M. Drucker, [phone]

David.Drucker(at)dailybulletin.com