In many states, behavioral health Medicaid carve outs are in jeopardy, but not in California. Why is that so?
It is difficult to go to a health policy forum and not hear people talk about ending the behavioral health carveout in MediCal. Health plans, federally qualified health centers, health policy “experts” all seem to advocate for such an action and not surprisingly many in the mental health community fear that this will happen and worry about the state not seeking renewal of the Section 1915 (b) Freedom of Choice Waiver which has been in place since 1995 creating counties as the single managed care entity for mental health. That waiver is up for renewal in June of 2015. Many in the mental health community appear worried that the state will not seek its renewal or that the federal government will not approve it. They further worry that if that happened the so called carve out by which these services are provided through counties instead of managed care plans would come to an end.
However, those worries appear to be misplaced. Moreover, even if the waiver did not continue, the county system would not go away without a vote of the people to overturn two voter approved ballot measures.