Medi-Cal Faces $1.7B in Funding Cuts Under Brown's Budget Plan

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The budget proposal that Gov. Jerry Brown (D) released on Monday called for $1.7 billion in cuts to Medi-Cal, California's Medicaid program, the Contra Costa Times reports (Kleffman, Contra Costa Times, 1/11).

The cuts to Medi-Cal are part of Brown's larger plan to close the state's estimated $25.4 billion budget shortfall over the next 18 months (Jewett, California Watch, 1/10).

For additional coverage of Brown's budget proposal, see today's California Healthline article and Capitol Desk post.

Details on Medi-Cal Cuts

Alan McKay, executive director of the not-for-profit Central Coast Alliance for Health, said Brown's proposed Medi-Cal changes primarily would affect the fee-for-service system (Contra Costa Times, 1/11).

A portion of the $1.7 billion in cuts would come from increasing cost sharing for Medi-Cal beneficiaries and imposing limits on service usage. The higher cost sharing could reduce state spending by about $557 million, while the caps on service usage could reduce state spending by about $234 million (California Watch, 1/10).

To enact such spending reductions, the Medi-Cal provisions of Brown's budget plan would:

  • Limit physician visits to 10 annually and limit prescriptions to six monthly, except for lifesaving medications;
  • Set mandatory copayments for beneficiaries at $5 per physician visit, $50 per emergency department visit and $100 per day for hospital stays up to a maximum of $200;
  • Cap annual spending for health products such as hearing aids, incontinence supplies and wound care; and
  • Decline services to patients who cannot provide a copay, as long as such patients are referred to a county-level indigent health care program (Contra Costa Times, 1/11).

In addition, Brown's plan would eliminate adult day health care services to reduce state spending by $177 million. The proposal also aims to reduce state spending by more than $900 million by cutting nursing home, physician, clinic, pharmacy and medical transportation rates by 10% (California Watch, 1/10).

Concerns From Health Care Providers, Advocates

Carmella Castellano Garcia -- who leads the California Primary Care Association -- said Brown's proposed Medi-Cal cuts could place a heavy burden on the state's community health clinics, which typically serve a high number of Medi-Cal beneficiaries.

Castellano Garcia said some community health centers might be forced to close as a result of the cuts ("KPBS News," KPBS, 1/10).

Anthony Wright, executive director of Health Access California, said the cuts would negatively affect the health of individual families, the health care system and broader attempts at economic recovery (Contra Costa Times, 1/11).

Wendy Burger
I feel that they want us to all die because we're disabled. I thought this was a compassionate nation. We are losing our Americanism and there will be multitudes who are left to die in the streets of their conditions while homeless if this is continued much longer. It was never the disabled, nor the elderly, nor the children's fault that the budget became upended. However, we are the ones who now must suffer for mistakes we did not create. And what about our returning veterans who sacrificed for the cause of this nation? Will they be turned down for care, too, and what if they're disabled and have few resources? Is this how we really want to treat those who would die for our country? Is this American?
Deborah DeStefano
Last week I visited my local county medical clinic. If there's so little money, then why are there 2 L.A. County Sheriffs at the door along with 5 security guards. The sheriffs threw me to the floor, pulled me by the arms while on my back and kicked me in the side while I was down. They did so many other illegal things, too much for here. I will never go back to any health care that treats you like a criminal. Who ever heard of having law enforcement at your doctor's office? I will no longer have any place to go for my care. Recovering from breast cancer surgery which gave me a frozen rotary cuff. I have an extremely painful back injury from an accident, have had a heart attack, have very high blood pressure and cholesterol. I will just have to voluntarily not seek treatment. I have Medi-Cal and will never be eligible for MediCare. I am a disabled senior on SSI. Fire all the Nazis, good place to start to cover health care costs. I'll just stay at risk rather than
Robert Forster
Lynette, you make some good passionate points. Despite the tone of our new governor he forgot to include the following in his proposed preliminary budget: 1. Nothing about regulatory reform to encourage more business from leaving 2. He protects state (SEIU) employees by all of his measures 3. Fortunately but regretably his Medi-Cal cuts still places California with the most elective/robust Medicaid system in the USA. Private citizens are moving to catestrophic or high deductable healthplans to reduce cost, yet we support MediCal with options way beyond other states--these could be temporarily suspended if desired in targeted areas. 4. Consolidation of state agencies and facilities--mayor savings here. Reduce the bureaucracy in education and let the school boards run the schools. We spend 2-3X/capita more than other states yet 48th. on Quality--give it a try. Vouchers?? 5. Most taxed state and actually economy in the world--yet considering "extending"-crazy. Rob MD
Lynette Graves
No special election to extend the so called temporary tax increases.Everyone on the states payroll should submit their suggestions on how they can be more efficient with less money.Universities & community colleges are suppose to be institutions of higher learning but they cannot figure out or understand that the state cannot continue to give them hundreds of million $$ year after year.A lot of local & state jobs need to be privatized;i.e. UC employees.We have consistently raised taxes it is time to give tax payers a break.To balance this mess we must make cuts to all these agencies that insist they need more and more government funding every year.Time to start trimming the fat, and waste from their programs the gravy train must come to an end.There is nothing cruel about it, this is a reality and if our legislators & educated qualified people that run these public agencies can't agree to make the necessary cuts without special elections, borrowing,& tax increases they need to resign.

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