Bay Area Budget bliss:
California’s public schools are likely to reap billions of extra dollars in the next few years.
Gov. Jerry Brown on Tuesday said that the state should oversee the expansion of its MediCal program as encouraged by the Affordable Care Act but that counties will have to give up funding used to care for low-income residents.
The state now sends about $1.5 billion annually to counties for health care for indigent Californians, many of whom are not currently eligible for Medi-Cal. But about 1.4 million residents will become eligible for Medi-Cal in January as the health law is implemented, reducing the cost burden on the counties for medical care, state officials said.
“While the need for county indigent services will continue and preserving a safety net is a
priority, the state cannot — and should not — pay for the same services twice,” Brown said in revised budget proposal, released Tuesday.
The revised budget also said that people who will be newly eligible for Medi-Cal will receive the same benefits as existing beneficiaries.
State health officials estimated the savings to the state would be $300 million this coming year and grow to $1.3 billion from 2015 to 2016. The savings will be used for other programs.
Health advocates criticized the plan because they said it means counties are going to be receiving hundreds of millions of dollars — and eventually more than a billion dollars — less to take care of the estimated 3 million to 4 million people in the state who will remain uninsured.
“It’s not that we should pay for the same person twice, it’s that we’re going to have remaining uninsured that we need to provide care for once,” said Anthony Wright, the executive director of Health Access.
The budget estimates that it will cost $1.5 billion in the first year to implement the Medi-Cal expansion, but the federal government will cover the full cost for the first three years of the Affordable Care Act.
“Under this proposal, it is actually the state that would be paid twice,” David Finigan, the president of the California State Association of Counties, said in a statement. “The federal government has pledged to pay 100 percent of the costs of insuring this new population for the first three years, so redirecting county funding right away is duplicative and unnecessary.”
Through a program called the Bridge to Reform, counties have already extended health coverage to 500,000 lowincome Californians, splitting the cost with the federal government. Most of those residents will be absorbed into Medi-Cal as the program expands.
The funding for the Bridge to Reform — known as a Medicaid Waiver — expires in 2015, but the governor’s budget proposal says the state plans to apply for another waiver to pull in more federal money.
The revised budget also said Medi-Cal was seeing $467 million in higher costs than was anticipated in Brown’s original budget four months ago, mostly because lawsuits have held up a cut to Medi-Cal reimbursement rates.
With California’s budget outlook brighter than in recent years, state lawmakers have been pushing to restore some of the cuts made to health services, including dental benefits for adults on Medi-Cal. But when asked at a press conference Tuesday if he had any plans to return funding for such programs, Brown had a blunt answer: “No.”
“The money’s not there … and we have incredible responsibility under the Affordable Care Act,” Brown said.