“Tough Budget for Tough Times”

Governor Brown has promised a “tough budget for tough times” in his January 3 inaugural speech, painting a grim future state funded services. With a projected $28 billion shortfall, cuts to many of the programs that were saved through hard fought budget battles under Schwarzenegger are looking nothing short of inevitable.

In the Health Services realm, it appears that the cuts that have been spared in previous budgets are back on the chopping block, though the Governor won’t release his budget until Monday. The silver lining in all of the budget suggestions coming from the new Governor’s camp is that Governor Brown is aware that the deficit can not be solved with cuts alone, and that revenue solutions must be considered in order to create sustainable solutions for California’s financial future.
Previously proposed cuts to health include:
Limit care and coverage for 7 million Californians including millions of seniors and people with disabilities and chronic illness, to save $90 million, including:
  • Limit doctor/clinic visits to 10/year to save $69 million.
  • Limit prescription drugs to 6 per month (except for life-saving drugs) to save $4 million.
  • Eliminate coverage for over-the-counter drugs to save $13 million.
  • Establish maximum benefit dollar caps on medical supplies (e.g., diabetes management test
  • strips & lancets, wound care, incontinence supplies) and durable medical equipment (e.g.,
  • wheelchairs and hearing aids) to save $3.8 million.
Raise the cost of care for Medi-Cal patients, the vast majority of whom are under the poverty level and have monthly incomes below $1,000, to save $218.8 million, including:
  • $100/day for a hospital stay, up to a maximum of $200, to save $59 million.
  • $50 copayment for emergency room visits to save $41.5 million.
  • $5 copayment for doctor visits and prescriptions to save $118 million.
Eliminate Medi-Cal coverage for recent legal immigrants to save $118 million, affecting about 90,000 legal immigrants who have resided in the US for less than five years;
Eliminate the Medi-Cal adult day health care benefit to save $104 million, affecting about 35,000 frail adults;

Eliminate coverage of Medicare Part B premiums for beneficiaries whose income exceeds the Medi-Cal eligibility threshold by less than $500 per month to save $1 million;

Freeze Medi-Cal rates for hospitals at current levels to save $65 million;

Reduce Medi-Cal rates for radiology to 80% of the Medicare rate to save $10.5 million;

Reduce Medi-Cal rates for family planning services;
Increase monthly premiums for families between 200 and 250 percent FPL by $18 per child, an increase of 75%, (with a family maximum of $126). $13.3 million General Fund reduction.

Raise emergency room co-payments from $15 to $50 ($2.5 million) and raising hospital inpatient services co-payments of $100 per day with a $200 maximum ($0.7 million), for an overall reduction of $3.2 million General Fund.

Eliminate vision care for children, including coverage for eyeglasses

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