California Budget Health Care Cuts and Choices Emerging in Committee Decisions

In the Senate, the budget committee’s proposal will head to the floor for a vote. In the Assembly, the full Assembly budget committee will still need to approve each sub-committee’s proposal before being perfunctorily approved by both houses with the intent that the conference committee -- made up three budget committee members from each house – will reconcile differences between each house’s working proposals. The Legislature is supposed to finish working on its budget June 15th, but that has only happened five times in the past 40 years.

The fiscal year begins July 1 – a mere 30 days from now -- and there is no expectation that California will have a budget on time.

ACTIONS TAKEN FRIDAY

Below is a listing of major decisions made by the Assembly Budget Subcommittee on Health and the full Senate Budget Committee. For a full list of actions taken this year, click here.

• Direct denial of coverage to very low income working parents: Would have denied coverage to parents earning wages between $11,000 and $18,000 a year (for a family of three). A parent would need to work fewer than 100 hours a month in order to qualify. REJECTED by both houses.

• Quarterly Status Reports for children and adults: Would have required Medi-Cal recipients to report any changes in their life every three months. Currently, children only have to report annually, and adults every six months. MODIFIED by Senate to require reports every six months for both children and adults. REJECTED by the Assembly.

• Medi-Cal rate reimbursement: Approved earlier this year, will reduce reimbursements to Medi-Cal doctors by 10%. California already ranks near the bottom (43rd) on reimbursements for providers in this program. Both houses sought to restore this already-made cut: REDUCED to 5% reduction by Senate. REVERSED by Assembly.

• Reduced benefits for legal immigrants: Legal immigrants who currently receive comprehensive Medi-Cal benefits would lose all but four services: emergency, pregnancy, some long-term and cancer care. REJECTED by both houses.

• Monthly reporting for immigrants: Would require undocumented immigrants to establish their eligibility for limited emergency Medi-Cal services every month. REJECTED by both houses.

• Elimination of dental benefits for adults on Medi-Cal: Would have eliminated the ability for adults on Medi-Cal to receive cleanings, crowns, filling or other oral surgery unless a physician treated them. REJECTED by both houses.

• Eliminate vital services for Medi-Cal recipients: Adults would no longer be able to see an optometrist, fill eyeglass prescriptions, obtain hearing aids, get speech therapy, treat sores caused by incontinence, see a podiatrist, chiropractor, acupuncturist or psychologist. REJECTED by both houses.

• Required very low-income seniors to pay more for their health care: Would have required seniors who earn $1,100 a month to either pay $100 premium for coverage to see their doctor, or spend half their monthly income on healthcare. MODIFIED by both houses to continue to pay premium for enrollees who do not pay $500 a month for health services.

• Premium increase for some Healthy Families subscribers: Would have increased Healthy Families premiums between 27% and 77% for subscribers between 151 to 250 percent of the poverty level. MODIFIED by both houses to increase premiums by half the amount proposed.

• Co-payment increase for Healthy Families subscribers: Families between 151 to 250% of the poverty level would pay $7.50 (rather than $4) for “non-preventive’’ services, such as prescriptions, some emergency room visits, some doctors visits, eye exams and glasses, therapy and dental work. REJECTED by both houses.

• Capping Healthy Families dental benefit: Would limit dental coverage to $1,000 per enrollee. MODIFIED. Both houses increased the cap to $1,500.

• Shifting money away from public hospitals: Takes federal money used for public hospitals to pay for unrelated programs. REJECTED by the Senate. REJECTED by the Assembly.
No action, including the rejection of cuts in both houses, is final unless the final budget is approved and signed into law by the Governor. However, the actions to reject many of these cuts sets the stage for the budget debate this summer: whether to deny care and coverage to millions of Californians, or whether the state raises the revenue to prevent these cuts. That's the clear choice.

Health Access will continue to track budget actions on the floors and in conference committee during the budget season.

Hanh Kim Quach is the Health Care Policy Coordinator for Health Access California. Before joining the organization, she worked as a journalist for nearly 9 years covering issues in California. Health Access California is a statewide health care consumer advocacy coalition of over 200 groups. This article has also been published on the Health Access Weblog.