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The California Progress Report is published by Frank D. Russo, a longtime observer of and participant in California politics.

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Capping California’s Prospects

Anthony-Wright.gifBy Anthony Wright
Executive Director of Health Access California

With all the rumors swirling about, let's be clear: Spending cap? Unless the details can address several key issues, we're opposed. And a temporary tax increase is not an incentive to change that position.

Health Access California has been devoting significant effort to working to prevent devastating health care cuts. But it wouldn't make sense to prevent some of those cuts now, in return for a spending cap that would force those cuts, and more, in the future.

There may be reforms to the budget process that do make sense--I'll mention that we were a leading voice and organizer in the campaign for Proposition 56 which had several ideas in it--since some policymakers are in the mood of resurrecting the provisions past ballot measures.

But most spending cap proposals I've seen have been fundamentally destructive to the health care system we all rely on. All Californians who care about health care should be wary, if not outright opposed.

• A spending cap is unlikely to take into account medical inflation, so when health care costs rise as a faster clip, that would create even more pressure to make cuts.

• Other areas of the budget have voter-approved protections and dedicated revenue streams that health and human services largely do not, making these vital services at greater risk of cuts.

• Finally, and most importantly, a spending cap condemns us to the health care system we have. It may keep us at 49th in the nation in Medicaid per patient spending, and having one of the largest uninsured rates in the country. It may prohibit coverage expansions and health reform in general.

When these budget issues occur, there are choices to be made to make the budget balance: make cuts? raise taxes? both? But we shouldn't pre-suppose to make those choices now, and to top the scales to force cuts, now and into the future.

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.

Posted on August 17, 2008

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