On Thursday, the Assembly Budget Committee is slated to vote on key budget proposals for the state’s 2017-18 Budget, including investments for the Medi-Cal program that covers over 14 million Californians, using revenues raised from Proposition 56 tobacco tax approved by voters last year. With some differences, the Assembly action mirrors action Tuesday by the Senate Budget Committee. An updated Health Access budget scorecard details the proposals.
Legislators argue that the voter expectation in passing Proposition 56 to raise tobacco tax dollars was to make tangible improvements in Medi-Cal, not to supplant existing and expected costs. The $1.2 billion raised by the tobacco tax provides the resources to restore and augment Medi-Cal benefits, take additional steps in expanding eligibility to young adults and seniors, and have a majority of funds focused on improving access through targeted provider rate increases, including for family planning, dental, and medical care.
HEALTH4ALL YOUNG ADULTS: Of particular note are proposals in both the Assembly and Senate to extend Medi-Cal to all income-eligible Californians up to the age of 26, regardless of immigration status.
Last May, California expanded Medi-Cal to all income-eligible children, and the program now covers 189,000 undocumented children. Both houses of the Legislature proposed to take another step to #Health4All by covering all young adults up to age 26, regardless of immigration status. Health and immigrant rights groups argues that our health system and communities are stronger when everyone is included, getting primary and preventative care especially when Californians are just starting out in life.
Before the ACA, young adults were the age group most likely to be uninsured, because they are likely still pursuing education and starting out in jobs without coverage. Even after the ACA, undocumented young adults often don’t have parents with insurance to get covered under, nor access to Medi-Cal or other programs. If the Governor agrees to expand Medi-Cal to more young adults, California can take a tangible and concrete step forward this year to universal coverage for all, a stark contrast from the debate in DC to decimate and defund our health system.
DENTI-CAL: Both houses of the Legislature also propose to restore and improve dental coverage in Medi-Cal, which was eliminated in 2009 and only partially restored in 2013. Currently, Denti-Cal covers primary and preventive care and full dentures, but not gum treatments, rear root canals, and partial dentures. Both houses also propose to increase dental rates to improve access, where there have been documented issues.
Other specific investments proposed by the Senate or Assembly include:
* Restoring other Medi-Cal benefits cut in 2009, including podiatry, vision, psychology, speech therapy, and more, and adding coverage for a diabetes prevention program model pilot.
* Expand Medi-Cal eligibility for aged and disabled up to 138% of the poverty level to align with other adults in Medi-Cal and reduce share of costs for low-income seniors.
* Improve access by increasing provider rates to family planning services, including Planned Parenthood and other providers; to dental services; and to Medi-Cal health providers in general. The Senate proposal aligns with Health Access recommendations to focus provider rate increases on “high need areas and specialty services.”
With this tobacco tax funding, California can finally fully restore dental, as well as vision, podiatry, and other benefits that were cut from Medi-Cal nearly a decade ago during the Great Recession, and help remedy the provider cuts that were made then as well. As the federal administration and their proposal to defund Medi-Cal by 47% in the budget released earlier this week, the state legislative proposals show a stark contrast, seeking to invest and improve the program that covers 14 million Californians and is the backbone of our state’s health system.
Health Access California’s scorecard details the dollars proposed for each of these elements