It’s official…

Friday, March 27th, 2009

Severe Health and Human Services “Trigger” Cuts To Go Through
* Nearly Three Million Californians to Lose Dental & Eight Other Services
* Cuts Would Counter Economic Stimulus & Intent of Medicaid Aid

More Updates on the Health Access WeBlog: Defining “Universal Access”; More on the “Trigger”; Prop 1A Update; Sen. Sanders Introduced Single-Payer; The Question is Moot.

Earlier today, Governor Arnold Schwarzenegger’s Director of Finance Mike Genest and California Treasurer Bill Lockyer announced that they are not pulling the budget “trigger,” thus letting additional cuts and taxes to go through.

In a letter released this morning, Treasurer Lockyer described his accounting of the federal economic recovery dollars, and determined that it did not meet the requirements in the law to prevent the nearly $1 billion in cuts:

The severe cuts being made in light of the “trigger” decision today would cut $183.6 million from health care, including from public hospitals and Medi-Cal benefits. The cuts would also prevent California from getting even more in federal matching funds as a result.

The cuts would eliminate dental, optometry, podiatry, psychology, and several other benefits for around three million California parents, seniors and people with disabilities. Health advocates argue that these cuts will incur new costs to our health system: these services often provide the preventative care needed to prevent full-blown, more expensive treatments later. For example, podiatry services often provide early-warning for diabetes and obesity.

In particular, health advocates argue that these cuts to Medi-Cal are counter to the spirit of the federal economic recovery package, which was supposed to prevent severe cuts in the safety net of the health system on which we all rely. New Medicaid funds were provided by the federal government with the notion of preventing cuts and being able to meet increased needs. Now, for every dollar we cut, California leaves even more money back on the federal table, money that our stretched health system and our struggling economy needs.

The “trigger” cuts included $183.6 million in health care cuts, including:

o a 10% cut to public hospital reimbursement rates (the Safety Net Care Pool), of $54 million, and

o eliminating specific Medi-Cal benefits for 3 million parents, seniors, and people with disabilities (Health Access has a fact sheet on the human and health impacts if these benefits are cut) including:
§ Adult dental
§ Acupuncture services
§ Audiology Services and speech therapy services
§ Chiropractic services
§ Optometric and optician services, including services provided by a fabricating optical lab
§ Podiatric services
§ Psychology services
§ Incontinence creams and washes

Some groups are exploring litigation against the “trigger” cuts and taxes. Others are seeking ways to fight for restoring some of the cuts.

Treasurer Lockyer, in a hearing last week, argued his decision was not to be of “policy” but only of “math.” However, he did urge restoration of some cuts, including to dental and home care. As he stated:

I am deeply concerned about all of these consequences, both fiscal and human. In particular, I believe two programmatic cuts will produce harmful consequences that greatly outweigh any savings. Slashing $200 million in State funds for optional dental benefits and the minimum pay guarantee for in-home supportive services workers targets people who most need our help. I consider the suffering that would be caused by these particular cuts to be both severe and compelling. Further, the effect of these reductions would be greatly amplified by the fact the State would forego additional Federal matching and ovennatching funds. For these reasons, I strongly urge the Governor and Legislature to reconsider at least these two programmatic cuts before they take effect on July 1.

The Medi-Cal benefits, including Denti-Cal, will continue through June 2009. These services will continue after that for children 21 and under, although advocates are concerned about ripple effects in terms of access. Some providers and dental clinics who are losing their adult patient population might not be financial viable.

More analysis about the budget is being posted regularly, and is available on the Health Access daily blog, at:

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

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