Not the worst, but pretty bad…

Tuesday, June 16th, 2009

* Budget Conference Committee Makes Big Health Cuts: $1 Billion in Medi-Cal, Many More
* Major Cuts, Not Full Eliminations of State $, for Healthy Families, AIDS Programs, Clinics
* In Order to Prevent the Worst of the Severe Cuts, Revenues and Taxes Needed

* More Updates on the NEWLY REDESIGNED Health Access Blog: More on Budget Cuts; The California Congressional Delegation Speaks Out on Health Reform and the Public Health Insurance Option; Health Bills Pending; Better Budget Choices for California

* Follow Health Access California on Twitter, at @healthaccess, or for quick updates on budget and health reform issues.

On Monday, the Budget Conference Committee of the California Legislature revisited some of the proposed cuts that they had delayed making last week during their first look at the Governor’s budget proposal. As with last week, the legislators have made severe cuts, but rejected even worse proposals.

The Committee, chaired by Assemblywoman Noreen Evans, made significant cuts but largely rejected full-scale eliminations of Healthy Families and a variety of other programs and services. Significant reductions were made for most of the cuts the Governor has proposed.

A one-page list of all the health care cuts proposed by Governor Schwarzenegger is at the Health Access website, at:

The decisions made Monday included:

* A $1 billion cut in Medi-Cal as part of “flexibility and stabilization” negotiations with the federal government, largely around “federal funds which are past due.” These include:
* $700 million that the state claims were disability expenses to the state that shold have been covered by the federal government, by enrolling those on Medi-Cal who are also eligible for Medicare due to disability more promptly;
* $75 million in redoing “clawback” calculations related to the implementation of Medicare Part D;
* An adjustment of Medicare Part B payments that should have been paid by Medicare, not Medi-Cal
* An effort to reclaim over $400 million from provisions in the current hospital waiver that was negotiated in 2005.
* It is notable that the list of possible reductions does NOT include provider rate cuts or the eligibility reductions that were originally raised and discussed when this proposal was first floated a few weeks ago.

* A $70 million cut to Healthy Families, which would establish and send children to a waiting list for coverage, unless other sources of funding or donations were made. (Last year, the First Five Commission provided $17 million to Healthy Families to prevent a waiting list from being established, but this is a significantly bigger hole to fill.) This cut is actually *bigger* than the Governor’s original $54 million cut to roll back eligibility for over 225,000 children between 200-250% of the federal poverty level. Without additional assistance, a $70 million cut could mean the Healthy Families program bars any new children from enrolling for a long while, denying well over two hundred thousand of children coverage.

* The rejection of the elimination of Medi-Cal coverage for *legal* immigrants (such as those with PRUCOL status).

* $34 million would be shifted from the distressed hospital fund rather than making the Governor’s cut to the state’s private Disproportionate Share Hospitals (DSH).

* A 30% cut to state funding of community clinic programs.

* A $11 million, rather than $16 million, cut to Maternal Child Adolescent programs, like the Black Infant Child Program.

* A cut of $35.5 million cut from about $80 million provided for AIDS and HIV programs, both education and prescription drug service programs.

* A $26.5 million reduction in Adult Day Health Care Centers, as opposed to a full elimination as the Governor and the Republicans on the committee supported. The compromise proposal would cap the use the ADHCx for 3 days.

* A cut to small and rural hospitals, narrower that what the Governor proposed.

* The cutting of nearly half, rather than all, of the state’s poison control system.

Republican legislators voted for the full elimination of these programs, including Healthy Families, the statewide source of coverage for nearly 1 million lower-income children.

The Republican legislators on the Committee–notably Assemblyman Roger Niello and Senator Bob Dutton—often berated their Conference Committee for waiting to make the tough decisions, and for not making these cuts… But Assemblymembers Evans and DeLeon and Senator Lowenthal spoke eloquently for need for other options, and to prioritize between spending cuts. But on AIDS programs and other such efforts, they made clear, “people will die,” if the program is eliminated.

More commentary will be available on the newly-redesigned Health Access website at, and our blog, at

Health Access California promotes quality, affordable health care for all Californians.

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