On Friday May 11th, Governor Jerry Brown released his proposed May Revision to the state’s 2018-19 budget, which continues California’s commitment to implement and improve on the Affordable Care Act (ACA), but still leaves around 2.8 million without coverage, and more Californians struggling to afford care. The Governor did not include any new health investments in his proposal, however, health and consumer advocates are urging that the state budget invest in covering the remaining uninsured and take new steps toward universal coverage, including expanding Medi-Cal and increasing affordability assistance in Covered California and the individual insurance market. The State Assembly recently proposed a $1 billion health care package for the next fiscal year, and a proposal from the Senate is forthcoming. Many of the proposals that the Assembly has adopted are mirrored in the Care4All California campaign, a campaign focused on bringing California closer to universal coverage without the need for federal approvals.
While this proposed budget continues the significant coverage gains under Affordable Care Act, Governor Brown offers no new help to the many Californians still struggling to access affordable health care. Especially when the federal government continues to undermine our health system in ways that would spike premiums, Health Access supports the priorities of the Assembly and Senate in seeking coverage expansions and additional financial assistance so Californians can better access and afford care. California can and should make a meaningful down payment to the goal of universal coverage, by expanding Medi-Cal and providing additional affordability assistance for those who purchase insurance individually.
Especially in our high cost-state, California should extend additional financial assistance so that more people can afford and sign up for coverage, making the system work better for everyone. While the Affordable Care Act took big steps towards the goal of universal coverage, we support the Assembly and the Senate seeking to fill the gaps in the current system. Too many middle-income families face cliffs in financial assistance if they are just over certain income levels. As the Trump Administration acts to depress enrollment and ultimately spike premiums, additional help to afford coverage can act as an antidote, increasing take-up and stabilizing the market.
The California budget should make needed restorations and expansions in Medi-Cal, a core pillar for the health system on which we all rely. We should close coverage gaps in Medi-Cal, in particular by removing the unfair exclusion on immigration status, and raising the income eligibility line for the aged, blind and disabled to match the rest of the population. We support the Assembly’s proposal to cover all income-eligible young adults in Medi-Cal regardless of immigration status, and also ask the Legislature to prioritize older immigrant Californians who have the most urgent health needs. Additionally, while we have restored vision and dental coverage, California should restore the other half-dozen benefits eliminated during the Great Recession, which include podiatry and speech therapy.
The current budget surplus was created based on the cuts made most notably to health and human services, and as such, the surplus should go to restoring benefits to our most vulnerable who have gone without for nearly a decade. Expanding coverage helps the health and financial security of not just the individual and family covered, but the community as a whole.
For a detailed breakdown of health care in the 2018-19 state budget, please reference the Health Access budget scorecard