HEALTH ACCESS UPDATE
Tuesday, May 26th, 2009
GOVERNOR PROPOSES ADDITIONAL CUTS TO HEALTH & HUMAN SERVICES
* Governor Seeks Elimination of Healthy Families, CalWORKS, Various Clinic Programs
* Medi-Cal Cut To Be Negotiated with Federal Govt Goes From $750 Million to $1 Billion;
* Cuts Would Deny Coverage for Dialysis, Cancer Treatment, HIV Testing, Mental Health, Etc.
* Cuts Would Harm Health System & Economy; Hundreds of Millions in Lost Federal Funds
* Governor Rejects The Long-Term Revenues Needed to Prevent Devastating Cuts
More Updates on the NEWLY REDESIGNED Health Access Blog: Listening to the Electorate; The Results of a Cuts-Only Budget; Eliminating Healthy Families?; Without Reform, It’s Getting Worse; Fighting Against So-Called “Flexibility”; The Budget Conference Committee; The Day After the Election; Getting to Universal Coverage
Today, Governor Arnold Schwarzenegger released details of new, additional cuts totaling over $5.5 billion to the state budget, on top of what he proposed a few weeks ago. And because of the continued deterioration in the economy, the Administration has promised to release by Friday another $3 billion in cuts to be considered on top of that.
On May 14th, he had proposed a variety of “budget solutions”–including many cuts and no revenues–to address a $21.3 billion deficit in the 2009-10 budget year, with some cuts contigent on the failure of Propositions 1C, 1D & 1E. Last week, he announced he was abandoning a plan to borrow over $5 billion dollars, and instead simply proposing to make additional cuts. Today’s list of cuts detailed those cuts, which include the wholesale elimination of Healthy Families, CalWORKS, CalGrants, CFAP/CAFI, Cand other programs and services.
The economic crisis has caused the budget agreed to by the Governor and legislative leaders to fall out of balance by a projected $3 billion additional dollars. Yet the Governor has yet to budge from his cuts-only approach to the budget, and has indicated he will seek even more cuts.
BUDGET CONFERENCE COMMITTEE HEARING TOMORROW: Tomorrow, Wednesday, May 27th, the Budget Conference Committee, chaired by Assemblywomen Noreen Evans, will take public testimony on the cuts to health and human services, starting at 9:00am in Room 4203 of the State Capitol. This may be the only public hearing that will allow testimony on these cuts. The agenda is as follows:
9:00 – 10:30 Medi-Cal and Healthy Families Program Issues
10:30 – 11:30 Public Health, Drug Medi-Cal, Prop 36, & Emergency Medical Services
Noon – 1:30 Developmental Services
1:30 – 3:00 In-Home Supportive Services
3:00 – 4:00 CalWORKs, SSI/ SSP , CFAP/CAPI
4:00 – 5:00 Child Welfare Services, Foster Care
COMMITTEE DISCUSSION ON NEW CUTS: The Budget Conference Committee heard the outlines of the new cuts today, which sparked some limited discussion, and calls from legislators for more analysis about the budget, financial, and economic, as well as health, impacts of these cuts.
Some members, like Senator Denise Ducheny, asked whether some of these cuts would not create more costs, as people end up in emergency rooms or elsewhere, even within the budget year. “What makes you think this doesn’t create a cost shift?… Will people just die and we won’t have to take care of them?” she asked.
Senator Mark Leno talked about how the AIDS Drug Assistance Program “literally keeps people alive,” and asked for information about the increased cost of ermegency room visits as a result of the cut. Senator Alan Lowenthal asked if there was a “longitudinal” analysis, and asked for the “long-range implications” of these cuts.
Assemblywoman Noreen Evans was alarmed when she noted that dialysis would be cut for some patients, exclaiming that her father was going through such treatment, and was not optional. She also noted that some cuts, like the elimination of HIV Testing, would have public health impacts. Assemblyman Kevin DeLeon pointed out the cuts to community clinics, arguing that for many Californians, “this is the only safety-net they have.”
THE NEWLY PROPOSED CUTS: The cuts detailed today include both increases in previously-announced cuts, and new services targeted for reductions or eliminations. They include:
* $302.3 million from the elimination of the Healthy Families program, denying coverage to over one million children. The Governor had previously proposed to limit eligibility to just twice the poverty level, to deny 225,000 children, but he has now expanded his proposal to include full elimination.
* $1 billion in unspecified cuts to Medi-Cal, through a negotiation with the federal government to cut eligibility. The Governor has proposed an additional cut of $250 million to the Medi-Cal program, adding to the already $750 million cuts already proposed in the May 14th budget. Using past eligibility cut proposals that the Administration continues to support, both the California Budget Project and Health Access have estimated that this cut could deny coverage to nearly 1 million California children, parents, seniors and people with disabilities.
* $34.8 million in additional Medi-Cal cuts to eliminate certain “state-only” programs that don’t get federal funds, thus denying coverage to specific populations for breast and cervical cancer treatment, postpartum care, dialysis, and non-digestive nutrition.
* $55.5 million in new cuts to the AIDS Drug Assistance Program (ADAP) to impose additional costs and restrict drug coverage for tens of thousands of Californians with AIDS. This proposal would also reduce or eliminate other Office of AIDS programs, including HIV Counseling and Testing, Epidemiologic Studies, Therapeutic Monitoring Program, and Home and Community Based Care.
* $34.2 million from the elimination of funds for various community clinic programs that provide preventative and primary care, including funding for Indian Health, Seasonal and Agricultural and Migratory Workers, Rural Health Services Development, and Expanded Access to Primary Care (EAPC).
* $20.2 million from the elimination of state funding for Maternal, Child, and Adolescent Health programs. This proposal goes beyond the significant cuts proposed on May 14th.
* $64 million in new cuts in Mental Health Managed Care Services.
* $28 million in new cuts to Early and Periodic Screening, Diagnosis, and Treatment Services (EPSDT), eliminating general fund support for certain county programs.
PREVIOUSLY PROPOSED CUTS: These cuts are on top of the cuts the Governor announced May 14th. Those that are not mentioned above include:
* $132.2 million in reduced health benefits to those in CALPERS;
* $125 million in reducing health services for legal immigrants;
* $60 million out of Proposition 99 funded-programs, redirecting money from county health funds, clinics, the Breast Cancer Early Detection, Asthma, rural health, the Access for Infants and Mothers program which provides prenatal care, and the Major Risk Medical Insurance Program, which provides coverage for those denied for “pre-existing conditions.”
* $36.8 million by cutting rates for family planning services;
* $25.5 million in reducing adult day health care benefits to three days a week;
* $24.6 million to local health jurisdictions of HIV education and prevention;
* $20 million by cutting payments to private hospitals, a 10% cut in general support; and
* $8.8 million through a 10% rate reduction for certain substance abuse treatment services in Medi-Cal;
* $2.9 million in suspending a comprehensive school-based prevention program on dental disease; and
* $2.7 million by eliminating application assisters that help children & families enroll in coverage.
In Medi-Cal, there is also a new prescription drug purchasing effort to save $75 million, and a new anti-fraud initiative targeted at adult day health centers, pharmacy, doctors, durable medical equipment, and transportation, with the goal of saving $47.9 million.
There are other human services cuts as well, to IHSS home care, SSI/SSP for seniors, and also includes the elimination of CalWORKS, as well as the elimination of CAPI and CFAP for legal immigrants. Senator Ducheny began to total that the cuts seemed to negatively impact over two million California children.