Initial reaction to the Governor’s May Revise

Here’s our initial comments on the Governor’s proposed 2014-15 May Revision of the Budget, which came out this morning.  



*        Budget shows success of Medi-Cal expansion and enrollment effort; Medi-Cal enrollment expected at over 11.5 million Californians, and increase that includes children from Healthy Families transition, and 900,000 currently in backlog

*        High enrollment and demand increases urgency for additional investments, to rectify cuts made in past years, to Medi-Cal and the safety-net. California has opportunity under the ACA to make relatively small investments that can provide big improvements to the health system for all Californians.

*        Budget leaves in place health cuts made in the depths of the recession, including a 10% reduction to some of the lowest Medicaid provider reimbursement rates in the nation, making it harder for patients to access doctors and specialists they need. Health providers and patients urge California to cancel the recession-era cut, take advantage of enhanced federal matching funds available. 

        Budget reallocates $725 million from county safety-net and public hospitals. This new formula, adopted in last year’s budget, forces need to address the remaining uninsured (such as with SB1005) to fulfull the promise of health reform.

Governor Jerry Brown released his “May Revise” proposal for the 2014-15 state budget, trumpeting the major increase in Medi-Cal enrollment under the Affordable Care Act. The May health budget makes no additional commitments beyond what was agreed to last year. The Governor’s budget leaves in place cuts made in the worst recession in 75 years, such as a ongoing 10% Medi-Cal rate reduction into the future, on some of the lowest Medicaid provider rates in the country. Here are comments by Anthony Wright, executive director, Health Access California, the statewide health care consumer advocacy coalition:

ON ENROLLMENT: “The Governor should be proud of our success in enrolling Californians in coverage, but this also increases the urgency to further invest in Medi-Cal and take advantage of all the new opportunities to improve the health system for all Californians. Most of the newly enrolled are 100% federally funded under the Affordable Care Act, and for a small state investment, we are bringing billions of dollars from DC to improve our health system and economy.” said Anthony Wright, executive director, Health Access California.

INVESTMENTS NEEDED: “The increased Medi-Cal enrollment provides new urgency to make sure Medi-Cal and our health system works, and to take advantage of additional dollars and opportunities after health reform implementation. The question under this budget is whether we continue the momentum of health reform, making key targeted investments to make major improvements in our health system.” said Wright. “Relatively small investments can actually improve access for those in Medi-Cal, and extend it to those still excluded from coverage–leveraging existing funds in a more efficient and effective way.”

MEDI-CAL RATES: “With millions more in Medi-Cal, we need to ensure these Californians have needed access to doctors and health providers. We need to cancel the recession-era 10% cut to Medi-Cal reimbursement rates, which were already 49th in the nation before the cut.” said Wright. “It’s counterproductive to enroll so many in Medi-Cal but continue with cuts to the providers who serve them.”

REMAINING UNINSURED: “The budget reallocates of $725 million dollars from county safety-net providers and public hospitals, which forces the need for a statewide solution on how to cover and care for the remaining uninsured this year.” said Wright. “We have made so much progress on getting Californians insured, but we could have made more if we weren’t stymied by communities and families where some were eligible for coverage and some weren’t due to immigration status.”

OVERALL: “We should remember that the surplus was created in part out of $15 billion in cuts to health and human services–cuts that continue today and into the future. It would be financially irresponsible not to revisit and restore more of the cuts made in the depth of the recession, including those that can bring in more federal matching funds to a health system and economy that needs it,” said Wright. “The level of services for California should not be set at the level of resources available during the worse recession since the Great Depression; there needs to be some balance between frugality and needed investments for the future. Rainy day funds are a priority, but should also be balanced with the pressing needs and opportunities.”