Budget Subcommittees Act to Restore Services and Expand Access to Medi-Cal

The Senate and Assembly Budget Subcommittees on Health and Human Services met this morning to take final actions on the Governor’s proposed budget and trailer bills and advocates’ proposals for augmentations and restorations. The full budget committees for both houses will be meeting in the coming days to act on subcommittee actions. We expect budget conference committee will convene before the end of the month to resolve the differences between the different budget proposals, and setting the stage for negotiations with the Governor.

Many of Health Access’ budget priorities were adopted at least in part by at least one of the subcommittees.

Restoration of Medi-Cal Cuts: The State eliminated non-federally mandated Medi-Cal benefits and cut provider rates during the fiscal crisis in 2009-2010. The budget subcommittees have voted to restore the cuts as follows:

  • Benefits: Both subcommittees voted to restore “optional” Medi-Cal benefits including acupuncture, audiology, incontinence cream/washes, optician/optical lab, podiatry, and speech therapy ($15 million). Chiropractic services are not proposed for any restoration.
  • Full Adult Dental: In addition, the Senate Budget Subcommittee voted to restore full adult benefits ($67.5 million). The 2009 budget eliminated adult dental benefits, some of which were restored in the 2013-14 budget. The Senate also voted to increase the dental anesthesia rate to provide rate parity between general anesthesia and dental anesthesia providers ($4.3 million). All of these items will go to conference committee.
  • Provider Rate Reductions: Medi-Cal provider rates were cut by 10% during the state fiscal crisis. The Senate voted to restore the rate cut for dental providers only ($30 million), while the Assembly voted to repeal the 10% rate cut for all providers by increasing rates by 5% on April 1, 2016 and by another 5% on April 1, 2017 ($32.75 million in 2015-16). Both of these items will go to conference committee.

Immigrant Health Care: Both Subcommittees adopted the Governor’s estimates and funding for covering immigrants newly eligible for Medi-Cal due to the President’s Executive Action on Immigration. This action continues California’s existing commitment to providing full-scope Medi-Cal to those who have deferred action status. The Senate also set aside $40 million to cover the remaining uninsured regardless of immigration status (as also proposed in SB4, Health4All). This item will go to conference committee. The subcommittee did not specify how eligibility would be determined, and these issues will be worked out through the budget or legislative process.

Public Health & Prevention Programs: Both the Senate and Assembly subcommittees voted to fund various Hepatitis C and HIV prevention programs, with the Senate investing $8 million and the Assembly proposing $6 million. These items will go to conference committee.

Medi-Cal Estate Recovery: Unfortunately, neither subcommittee acted to include limiting Medi-Cal estate recovery to the minimum federal requirements in their budget actions. Health Access and other advocates strongly believe that older low-income Californians should not have to make a trade-off between seeking health care coverage and keeping their family home. California needs to limit Medi-Cal estate recovery to costs associated with long term care services and supports, consistent with minimum federal requirements. Last year, the Governor vetoed a bill to limit Medi-Cal estate recovery, arguing the policy change should be considered in the budget instead. We will continue to push for changes this year, through Senator Hernandez’s SB 33 and in budget discussions.

What’s Next: The Senate Budget Committee will meet tomorrow (Friday) morning to review and act on subcommittee actions. The Assembly Budget Committee will meet Wednesday (May 27) to do the same. We expect a budget conference committee to convene shortly thereafter.