As the Budget Conference Committee in the California Legislature is about to begin its deliberations, a couple of reminders.
1) The cuts being discussed are ugly. The proposed cuts by the Governor would deny coverage to over a million Californians, and reduce access to care and coverage to millions more, and defund and undermine the health system on which we all rely.
For six and a half million children, parents, seniors, and people with disabilities, their Medi-Cal coverage will be harder to get, harder to stay on, and for those who keep it, they will have reduced ability to get the benefits and access to the providers they need.
2) The decisions around the budget will have a decisive impact on health reform, at the state level, and even at the national level. These proposed health cuts would go in the exact opposite direction of the policy reforms our broken health care system needs. If adopted, the Governor’s proposed cuts take us further from the goal of health reform: it digs a bigger hole, that will need to be filled before embarking on additional expansions.
Medicaid and SCHIP (Medi-Cal and Healthy Families in California) are the groundwork for health reform, on which additional expansions are built–but that only works their funding is strong and sustainable.
Regarding of the plan, from single-payer to a Massachusetts-style proposal to any public program expansion to anything else, any health reform and coverage expansion presupposes that we will need significant subsidies for lower-income families, who simply won’t be able to afford coverage by themselves. Yet by significantly cutting public programs that exist now–which are incomplete in policy and practice already–we have less to work with.
If these cuts are made, reformers will have to raise all those additional resources elsewhere–a major task indeed. In the effort for universal health care:
* For every dollar cut from the health care budget by California and other states, that’s a dollar that we will have to raise later.
* For every child or parent that loses coverage, that’s a child or parent that we are going to have to re-find and enroll later.
* For every policy change to place more administrative barriers to getting care and coverage, that’s just more we have to do later.
In other words, the greatest threat to health reform in 2009 may not be the insurance industry or even voter distrust (although they are significant obstacles as well), but the budget crisis and the state Governors and legislators who are making these health care budget cuts around the nation, and are undermining the foundation on which we need to build.