Governor Brown’s Budget for California: Medi-Cal and our May Revision Reponse

On Thursday, Governor Jerry Brown released his proposed May Revision to the state’s 2017-18 Budget, proposing few changes to the Medi-Cal program that covers over 14 million Californians, despite the previous week’s House vote on a health care bill that would make massive cuts to the program. The U.S. Senate has already begun to debate budget resolutions to end health coverage and financial assistance to five million Californians through a simple majority repeal vote of the Affordable Care Act.

In contrast to last week’s House vote to make massive cuts to Medicaid, California should continue to invest and improve our Medi-Cal program, which covers over 14 million Californians and is a pillar of the health system we all rely on. The Governor’s proposed budget is correct to not make premature cuts until a federal bill actually passes, but this budget should also make the Medi-Cal investments that voters expected with the tobacco tax revenue they raised, through restoring benefits, expanding eligibility, and increasing access.

ON PROP 56 INVESTMENTS: Prop 56’s tobacco tax dollars were not intended to supplant existing dollars but to make tangible improvements o Medi-Cal. With these investments, the Legislature can heed the wishes of Californians who voted three times and by large margins last November to support Medi-Cal, including supporting two measure to raise taxes to do so. 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. California can take another step to universal coverage by building on our successful expansion of Medi-Cal to all children, to also cover all young adults up to age 26, regardless of immigration status. The $1.2 billion raised by the tobacco tax is enough to restore and augment Medi-Cal benefits, take additional steps in expanding eligibility, and have a majority of funds focused on improving access through targeted provider rate increases, whether for dental, family planning, specialists, or other areas with identified issues.

ON THE FEDERAL CONTEXT: Governor Brown is right about Trumpcare–our first focus must be to fight this federal rollback, because the level of cuts proposed is ugly if not unthinkable–and on a scale that our state may be unable to recover from. The House GOP health bill would not only leave 4-5 million Californians uninsured and hike health costs for millions more, but blow a gigantic hole in Medi-Cal and the state budget. The annual cut to California in Medi-Cal and Covered California from the House Republican bill is over $24 billion–the same magnitude as what the state spends on all of higher education and all of corrections, combined. The worst provision of many in the House bill would cap and cut Medi-Cal which would not just eliminate the money for the expansion, but cap funding for all 14 million Californians who depend on the program. It was shocking to have any California Congressmembers vote for this horrible bill which would devastate our state’s health care system, much less all 14 of our state’s congressional Republicans. Given the severity of the Congressional cuts proposed, California should be close to DEFCON 1 in our response.