The governor and legislature negotiated a $115.4 billion budget deal, which was signed June 24th, that makes important investments in programs that will improve the health and overall quality of life for some of California’s most vulnerable populations. Congratulations to our lawmakers for committing to the following in the 2015-16 fiscal year:
• Expanding full-scope Medi-Cal to all children, regardless of immigration status Starting no sooner than May 2016 over 170,000 undocumented children under age 19 will be entitled to full-scope coverage. The full fiscal year cost is projected to be $132 million. With this policy the administration is setting the pace for the rest of the country when it comes to implementing policies that make sense both ethically and fiscally. Two senate bills currently being considered by the legislature, SB 4 and SB 10, also seek to expand health coverage options for undocumented Californians. SB 4 would extend unsubsidized access to Covered California plans to undocumented adults and make some technical fixes to the transition to Medi-Cal managed care for undocumented children next spring. SB 10 is a two-year bill seeking to make full-scope Medi-Cal available to undocumented adults who meet the 138% FPL limit.
• Reversing the 10% reimbursement rate cuts for Denti-Cal providers Denti-Cal providers have not had their rates increased since 2000 and a December 2014 audit found serious deficiencies in consumer access to Denti-Cal services. This policy change shows that the legislature is open to addressing challenges in Denti-Cal.
• Establishing an Earned Income Tax Credit According to the May Revision, two million Californians will be able to claim $380 million in tax credits. This is a momentous step toward lifting Californians out of poverty.
• Increasing childcare support Adding 7,000 preschool slots and 6,800 childcare slots helps low-income families who rely on these slots to pursue job opportunities, which in turn will allow them to be prosperous citizens of California.
• While these investments move California in the right direction, the final budget does not address some important gaps that remain in the safety-net. Over the coming months, CHC will continue advocacy that urges the administration and the legislature to address the following issues:
• Reinstatement of “optional” Medi-Cal benefits In 2009 acupuncture, audiology, incontinence creams/washes, optician and optical lab services, podiatry, and speech therapy were eliminated because they are not federally mandated. However, these benefits are essential to the state’s overall goal of providing Californians with integrated, coordinated systems of care.
• Full restoration of adult Denti-Cal benefits Due to only a partial restoration in 2014, Denti-Cal still fails to cover periodontal disease treatments and partial dentures. Half of the U.S. population over the age of 30 has periodontitis, which affects socioeconomically disadvantaged populations like Denti-Cal beneficiaries at a significantly higher rate. Furthermore, partial dentures restore people’s ability to chew and speak which has a significant impact on employment opportunities.
• Increase Medi-Cal provider rates Before state mandated cuts took effect in January 2015, California’s physician fee was the 47th lowest in the nation. Those cuts combined with the expiration of a temporary federal rate increase amounts to about a 60% reduction in primary care reimbursement. Furthermore, Medi-Cal rates for primary care are only 43% of Medicare reimbursement rates and as a result providers are more likely to accept Medicare than Medicaid patients.
• Limit Estate Recovery to what is federally required For those who made it through the recession without losing their homes, estate recovery creates fear and causes many to make an unnecessary choice between their health and their family’s future.
• A special legislative session was established by proclamation on June 19th to address healthcare financing and spending issues. The governor’s primary concern is securing stable funding for Medi-Cal after the loss of the managed care organization tax, but he has also suggested that Medi-Cal provider rate increases will be another topic to be addressed. The session is planned to take place this summer. CHC will continue to monitor this issue.
The governor’s final budget is posted at www.ebudget.ca.gov/.
– Community Health Councils