When you thought the budget couldn’t get worse…

HEALTH ACCESS UPDATE
Tuesday, July 28th, 2009

GOVERNOR’S LINE-ITEM CUTS DEVASTATE CALIFORNIA HEALTH CARE
* $50 Million More in Cuts to Healthy Families; Over 900,000 Kids to Be Denied Coverage

* Additional cuts to HIV/AIDS Care, Community Clinic Funding, Maternal/Child Health Programs, Medi-Cal County Administration, and Key Human Services

* Shocking, Large, Outrageous Cuts Will Deny Coverage & Care to Hundreds of Thousands of Californians, Impact Health System On Which We All Rely, and Hurt Our Economy

* More Updates on blog.health-access.org: Are These Cuts Legal?; Updates on Federal Health Reform; Wonkery on the Weekend; The Challege of August Recess for Reform; Governor Schwarzenegger’s Knife; Reaction to the Passage of a Budget; The President Lays Our What’s In It For You; The Governor’s Budget “Reforms” of Medi-Cal; and much more…

* Follow Health Access California on Facebook at www.facebook.com/healthaccess and on Twitter, at @healthaccess, or www.twitter.com/healthaccess for the quickest updates on budget, legislation, and federal health reform.

Governor Arnold Schwarzenegger today signed a budget reduction package today, including an additional $600+ million in unilateral and controversial cuts, largely to health and human services.

BACKGROUND: In February 2009, the Governor signed a budget for the current fiscal year that included $15 billion in spending cuts to health and other vital services, as well as a spending cap plus five other proposals that voters rejected in a special election on May 19, 2009.

With the economy worsening, the Governor and the Budget Conference Committee proposed solutions to fill the growing budget deficit, a final budget was passed last week that was largely negotiated by the Governor and legislative leaders. Combined, the February and July solutions signed by the Governor, close a $60 billion budget gap in the state’s General Fund.

Governor Arnold Schwarzenegger today signed the budget that was passed last week, but not before making $650 million in additional “blue pencil” reductions. Over $516 million were in specific line-item veto cuts, with over $400 million of those to health and human services. The added cuts were jaw-dropping to many advocates for health and human services.

The Governor has zeroed out some programs, such as some state funding for community clinics, and others were preserved in name only. Healthy Families, which has grown over a decade to cover nearly one million children, will not be the same program, as it is now shuttered and will likely be actively kicking kids off coverage.

THE ADDITIONAL CUTS made unilaterally by Governor Schwarzenegger today include:

* An additional $50 million cut to Healthy Families, raising the total shortfall for the program to $194 million, well over half the program’s state funding. As a result, Healthy Families will likely deny coverage for over 900,000 children, including actively disenrolling hundreds of thousands of kids, yanking their coverage away. This one budget cut would double the number of uninsured children in the state of California, undoing a decade of progress.

* Additional cuts of $52 million to programs under the Office of AIDS Prevention and Treatment, including education and prevention, therapeutic monitoring, counseling and testing, early intervention, home and community-based care, and housing.

* An additional $25 million cut that would eliminate state funding for community clinics, including Expanded Access to Primary Care. This is especially devastating when the number of uninsured are increasing, partially due to other cuts.

* An additional $12 million in cuts to Maternal, Child and Adolescent Health local assistance programs, including the Adolescent Family Life Program and the Black Infant Health program.

* An additional $60 million in Medi-Cal county administration, making it harder for California children, parents, seniors and people with disabilities to get on and stay on Medi-Cal coverage.

Other human services cuts include:

* An additional $80 million cut to funding for the Child Welfare Services Program, which responds to reports of abuse and neglect.
* An additional $50 million cut to funding for Regional Center services for children up to age 5 who have developmental disabilities.
* An additional $40 million in cuts to In-Home Support Services (IHSS) home care, further reducing eligibility.
* An additional $16 million in cuts to domestic violence programs, largely battered women’s shelters.

Consumer and community groups point out that California has better choices than to deny coverage to hundreds of thousands of children, or to make such devastating cuts to the health system on which we all rely. Check the Health Access website (http://www.health-access.org) and blog (http://blog.health-access.org) for the most up-to-date information.

THE OVERALL HEALTH BUDGET signed today, including the cuts made today, include the following cuts to health care:

* Denying hundreds of thousands of children health coverage. The Healthy Families program current covers nearly one million low-income children between 100-250% of the federal poverty level. The proposed cut of $194 million in state dollars (well above the recommendation of the Budget Conference Committee) would deny over 900,000 children coverage. First, the newly-imposed wait list would deny over 350,000 children over the course of the budget year. Second, the size of cut would force California to actively disenroll over 500,000 additional children–based on an assumption that the children would be kicked off during the time of annual renewal. depending on when they are disenrolled. In addition, for every dollar we cut in Healthy Families, we are losing two dollars in federal matching funds for our health system, and our economy.

* Making severe cuts to prevention-oriented and core health programs. While rejecting outright eliminations, the Budget Conference Committee made drastic cuts to a series of health care programs and services. The budget also includes:

o Cutting mental health, including reducing by $92 million of funds for the Mental Health Managed Care Services, and the Early and Periodic Screening, Diagnosis and Treatment program. A $14 million cut would eliminate state money for ancillary health services in Institutions for Mental Disease.
o Cutting HIV/AIDS care, reducing funding by $85 million.

o Cutting Adult Day Health Care, limiting it three days a week and other changes, a $26.8 million cut
o Cutting hospitals, taking $23 million from the Distressed Hospital Fund
o Cutting funding for community clinics, zeroing state general fund support for programs like Expanded Access to Primary Care, (with cuts also to the Rural Health Services, Seasonal Migratory Worker and the Indian Health Program).

o Cutting maternal and child health care significantly, including the Black Infant Health Program; Adolescent Family Life Program, and others.
o Cutting last-option health coverage for those rejected for “pre-existing conditions”, reducing the Major Risk Medical Insurance Program by $6.6 million. MRMIP already has a waiting list, with 7,100 enrollees, despite estimates of over 400,000 eligible “uninsurables.”
o Cutting health coverage for mothers and newborns babies to get prenatal and post-natal care, reducing the Access for Infants and Mother program by $4.9 million. The cut would force a waiting list, basically denying care to pregnant women.

o Cutting all of the Immunization Program, for $18 million.
o Cutting community application assisters that help enrollment in public coverage like Medi-Cal and Healthy Families, for $3 million.
o Suspending a children’s dental disease prevention program, for $3 million.

* Advancing controversial Medi-Cal proposals that would make it harder for patients to get the care they need.

* One provision would seek to privatize county eligibility workers for Medi-Cal and other human services. As reported in the media, the legislative leaders agreed to a process to consider the Governor’s recent proposal to privatize and replace the current county workers who assist Californians enrolling in Medi-Cal and other social services with a private contractor like Maximus or Halliburton. The reports indicate that the consideration would allow stakeholders to vet the proposal and requires legislative approval.
* Another provision would mandate managed care for seniors and disabilities on Medi-Cal. Consumer advocates have been long concerned about the impact on patients and their access to care and specialists, as well as funding impacts to safety-net institution.

It’s important to note that these and other cuts are on top of the cuts made in February 2009. Those cuts included the elimination of 10 benefits, including dental coverage, for the nearly 3 million adults (parents, seniors, and people with disabilities) with Medi-Cal coverage. Those went into effect recently on July 1, 2009.

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

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