2020-21 State Budget Deal Protects Many Key Health and Health Human Services – But Tough Cuts Made, and More Loom without Revenues

Governor Newsom and the California legislative leaders have announced a state budget deal today that pulls back many of the cuts to vital health and human services proposed in the May Revise, keeping this coverage and care intact as the state works to combat the COVID-19 pandemic.

While some significant cuts were made, this budget deal staves off the worst of the proposed health care cuts which would have denied coverage to tens of thousands of low-income seniors, and cut benefits and access to health providers for millions more on Medi-Cal. The budget deal does still rely heavily on federal aid, which is currently pending in Congress. Health care advocates continue to call on the Federal Government to step in with financial help to ensure that these cuts are not made, while also calling on state leaders to raise state revenue to ensure that these services are sustained into the future.

We are relieved that California will not adopt the worst of the proposed cuts to health, education, and other vital programs, but we need federal funds and state revenues or we’ll be back to considering cuts again.

In the middle of a pandemic, California should not deny coverage to tens of thousands of low-income seniors, or access to benefits and health providers for millions more. We should be investing in these programs, not debating cuts and delaying coverage to Californians simply due to their immigration status. We still face an urgent need to raise the revenues to sustain these safety-net services, and to make the investments to recover from the emergencies we now face of public health, economic recession, and gaping inequality.

CUTS MADE

As the Health Access Budget Scorecard shows, this budget deal does make tough cuts that are counterproductive in this coronavirus crisis. Most notably, many health and immigrant right advocates are disappointed in the indefinite delay for expanding Medi-Cal to seniors regardless of immigration status. The Legislature’s previously planned to delay the expansion to January 2022, but now the delay will be tied to an algorithm regarding future state surpluses. In addition, the budget deal reduces (but doesn’t eliminate) allocations for affordability assistance for those buying health coverage in Covered California.

In the middle of a public health crisis, our top priority should be retaining and expanding health care coverage. We are disappointed in the delay in extending Medi-Cal to cover all income-eligible seniors in Medi-Cal regardless of immigration status. Seniors can’t wait indefinitely for comprehensive health care, especially as this coronavirus crisis looms. Now is the time to expand coverage to our undocumented seniors who have made a lifetime of contributions to California, and who are suffering disproportionately during the COVID-19 pandemic.

The millions of Californians who have recently lost their jobs and coverage should be better protected in a pandemic, to ensure they have care for themselves and their loved ones. Folks losing coverage should have access to Medi-Cal, or be shielded from the sticker shock of high premiums when having to buy coverage in Covered California as an individual. During this public health emergency, we need to invest more, not less, to connect more Californians with coverage and care.

CUTS PREVENTED

In the middle of a pandemic, health advocates were pleased the budget did not adopt cuts to deny coverage to tens of thousands of low-income seniors, by reinstituting the “senior penalty,” estate recovery, and other eligibility fixes approved in the past several years. The budget deal preserves medically necessary benefits for millions of adults with Medi-Cal coverage, including vision, audiology, podiatry, and some dental services. Of particular note is the continuation of Community Based Adult Services (CBAS) and Multipurpose Senior Services Programs (MSSP), which help keep seniors and adults with disabilities independent and in their own homes and out of institutionalized care where COVID-19 deaths have been more prevalent. Finally, the budget delays cuts to health providers, such as redirecting Prop 56 funds for community clinics and other Medi-Cal providers–but sets that for another time. Health Access has updated its 2020 Budget Scorecard to track specific health care items in the new budget deal.

What this budget deal means is that tens of thousands of low-income seniors will be able to get comprehensive coverage through Medi-Cal, to take care of their condition, including those that exacerbate the effects of COVID-19. This budget deal means millions of Californians on Medi-Cal will continue to have key benefits covered, and not have their access to a community clinic or provider cut–at least not in the next year. This budget also preserves the ability of a senior or person with a disability to stay independent, and not have to enter a nursing facilities which have been where a plurality of the COVID-19 deaths are reported.

REVENUES NEEDED

As active as we have been in advocating for necessary federal funds, we recognize that even with that help California will need new revenue to prevent these cuts to health, education, and other vital services. We need real, systematic change to our budget and tax structure that puts more onus on the wealthy, who have benefited during the pandemic, to invest in our struggling communities and improve equity in public programs and systems.

Without revenues, California will be forced to revisit the proposed cuts, which hurt our ability to have families connect with needed care and coverage, hinder economic recovery from the pandemic, and exacerbate long-standing racial and other inequities. California will ultimately need both federal funds and additional state revenues to sustain these essential services, including health care and coverage for millions.

Our California legislators have appropriately prioritized protecting our health care system and safety net from cuts that are not only cruel but counterproductive in helping us get out of this economic and public health crisis. We now need them to raise the revenue to make these health services sustainable.

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