2021-22 CA Budget Takes Major Steps to a More Universal & Equitable Health Care System

For Immediate Release: Thursday, July 15, 2021

Rachel Linn Gish, director of communications, Health Access California, rlinngish@health-access.org, 916-532-2128 (cell)



Final Health Budget Bill Adopts Key Priorities of the Care4All California Coalition 

SACRAMENTO, CA – Today the State Legislature passed the final 2021-2022 health budget bill (AB 133) that includes historic investments in expanding and improving health coverage for millions of Californians. It now goes to Governor Newsom for his final signature in the coming days. Many of the proposals included in this budget bill were key priorities of the Care4All California coalition of over 70 consumer, community, labor, progressive, and health care organizations working to advance the goal of quality affordable health care for all Californians as soon as possible.

The coalition supported these investments which, working together, represent important steps to a more universal, equitable, and affordable health care system in California. These organizations pushed for key proposals to improve Medi-Cal and reduce health care disparities for low-income Californians and communities of color that made it into the final 2021-22 budget, including:

  • Expanding Medi-Cal, in a first-in-the-nation action, to cover 235,000 income-eligible undocumented immigrant adults age 50 and over.
  • Ending the assets limit for seniors and people with disabilities to access Medi-Cal, making CA the first state to fully end this antiquated rule that prevented 18,000 from enrolling in our state Medicaid program.
  • Improving Medi-Cal coverage for pregnancy and post-partum to reduce inequitable maternal mortality rates for black and indigenous women.
  • Creating culturally and linguistically appropriate Medi-Cal documents.
  • Continuing Cal-AIM reforms to improve and streamline the Medi-Cal program.

Together these investments will provide over 250,000 more Californians with health coverage through Medi-Cal and improve the program for the more than a third of Californians – and half of California’s children – who are enrolled in Medi-Cal.

In addition to these major Medi-Cal reforms, the coalition also worked to improve affordability for many Covered California enrollees that were included in the final budget:

  • Subsidizing state-only coverage by one dollar, allowing hundreds of thousands of low-income Californians to get true zero-premium plans.
  • Building a new Covered California affordability reserve, and directing Covered California to develop options for further reducing cost-sharing, such as for high deductibles and copays.

One major piece supported by the campaign that is still under negotiation is the creation of an Office of Health Care Affordability – an effort to tackle the rising cost of care with a more coordinated, holistic approach. First proposed by the Governor in his January budget, the Legislature agreed to create this new Office in order to collect and analyze information and identify trends in health care prices. This data would be used to set enforceable cost targets and includes accountability measures for those not meeting the goals. Negotiations with different stakeholders in the health industry are continuing.

More details in this factsheet from Health Access

Since 2017, the Care4All California campaign has worked on what can be done at the state level to build and improve upon the federal Affordable Care Act, without the need of federal interventions or an act of Congress. ​​​These wins this year join previous gains the coalition has helped make in California such as instituting first-in-the-nation state subsidies to help more low- and middle-income Californians afford coverage in Covered California, expanding Medi-Cal to young adults regardless of immigration status, implementing more tools to fight the skyrocketing cost of prescription drugs, and making our health system more accountable to ensuring equity and higher quality care.

Here is reaction on the budget bill’s passage from key leaders of the #Care4AllCA campaign including Health Access California, Western Center on Law & Poverty, California Immigrant Policy Center, California Pan-Ethnic Health Network, The Children’s Partnership, SEIU California, NextGen California, and the California Physicians Alliance:

“This budget takes big steps toward a more universal and equitable health system, building on the progress California has made implementing and improving on the Affordable Care Act over the last decade. The removal of unfair exclusions in Medi-Cal, and making Covered California more affordable, will make it easier for hundreds of thousands of Californians to get on and stay on coverage. The pandemic reminded all of us of the urgency of health care and coverage for not just ourselves, but our fellow community members; this budget makes big strides toward a better health care system that we all rely on.” –  Anthony Wright, Executive Director, Health Access California.

“The budget makes important progress towards ensuring that all Californians can access the health care they need. We are especially excited that soon Medi-Cal will cover those age 50 and older who but for their immigration status would already be eligible, and that Medi-Cal will phase out the asset test that forces elders and some people with disabilities to choose between savings and health care. We’re also happy to see Medi-Cal extended for postpartum people, as well as the inclusion of doula care, as important efforts to decrease health disparities faced by Black and indigenous parents. We look forward to continuing the work to achieve quality, affordable health care for all.” – Jen Flory, Policy Advocate, Western Center on Law & Poverty

“Access to Medi-Cal is life-changing for undocumented older adults and their families across California. Communities and advocates have worked for years to ensure that all Californians can have access to health care, and we are thrilled that our state leadership has removed exclusions for adults over age 50 to access essential preventative care through Medi-Cal. Everyone who calls California home, regardless of their birthplace or income, should have access to the care they need to stay healthy and live full lives. We will continue to advocate until no Californian is excluded and we can finally have health for all.” – Cynthia Buiza, Executive Director, California Immigrant Policy Center.

“We thank the Governor and the legislature for passing numerous Care4All California priorities that will expand equity in our health care systems for millions across our state. From expanding health care to undocumented seniors ages 50 and up, to funding community-based organizations to review Medi-Cal documents for cultural and linguistic competency, to funding the Health Equity and Racial Justice Fund as part of a $300M ongoing funding package starting next year; this budget takes multiple opportunities to expand health care regardless of race, gender, sexual orientation, class, ability, and immigration status. We look forward to continuing to reduce health care disparities and inequities through our systems, policies, and budgets.” – Kiran Savage-Sangwan, Executive Director, California Pan-Ethnic Health Network

“The Children’s Partnership recognizes that racial justice and equity are paramount to the well-being of California’s children and families. We are excited about the success of a number of Care4All budget priorities that  begin to address the specific needs of children and families from marginalized communities through a whole child, whole family approach, including Medi-Cal 12-month postpartum coverage and increasing access to health coverage regardless of immigration status for people over 50. However, more must be done to support our state’s children, particularly our youngest who are at a critical stage of their life, when 90 percent of brain development occurs. This includes addressing gaps in coverage that lead to disruptions in care for physical and mental health needs by providing continuous coverage for young children ages 0 to 5. We also continue to uplift the need for additional and explicit investments that support early childhood mental health in community settings, such as child care and development programs, where services are most likely to reach low-income children of color. The Children’s Partnership is encouraged by the legislature’s interest and is eager to support the administration in implementing this policy before the unwinding of the Public Health Emergency. We look forward to continuing to advance a whole health and prevention agenda that meets children and families where they are.”- Kristen Golden-Testa, Health Policy Director, The Children’s Partnership

“This year, SEIU members came together to fight for a budget that would lead us forward from the crisis of the pandemic into a more resilient and equitable society. We knew that fundamental reforms to our healthcare system would be the cornerstone of that process.  With this budget, California is taking tremendous strides forward in our goal of ensuring universal healthcare by including more of our undocumented family members, neighbors, and community members in our healthcare system. After years of speaking out about the injustice of the arbitrary home care hours cut, we are finally turning the page on that harmful and dangerous chapter. And we are beginning to reverse decades of neglect of our local public health infrastructure, which serves to combat health inequities and protect all of our communities. Our work is far from done: Brown and Black Californians demand continued and greater investment in our communities, in our health, in our children, in good jobs, and in an equitable recovery.” – April Verrett, President of SEIU Local 2015 and an Executive Board Member of SEIU California

“The state’s budget is a reflection of its values and this year’s California state budget made significant investments to improve our healthcare system. From expanding Medi-Cal coverage to undocumented seniors to removing the inequitable asset test for the elderly to reimagining the infrastructure of our health care delivery system with CalAIM — there is much we can be proud of.  Although these investments are a step in the right direction – we still have a long way to go. Years of racial disparities have been brought to light those hit hardest by the pandemic, underscoring the importance of providing equitable, affordable, and quality healthcare coverage to everyone. The Care4All California Coalition stands ready to collaborate and ensure we collectively reach this goal. ” – Elena Santamaria, Policy Advisor, NextGen California

“As a physician-led statewide nonprofit organization, CaPA elevates the voices of healthcare professionals and is helping create an equitable healthcare system in which our future healthcare leaders will practice. CaPA is a proud member of the #Care4AllCA coalition and is ready to continue working alongside so many California organizations and legislators who also believe that healthcare is a human right!” – Beatriz Sosa-Prado, M.S., Executive Director, California Physicians Alliance (CaPA)