Lawmakers and health care experts around the state may not know what to make of it if this turns out to be the first January in a long time without significant new cuts to health care services and programs in California.
Although revenues from Prop. 30 will help fund education, if it hadn't passed on Tuesday, the Legislature would be facing yet another massive budget shortfall and lawmakers would need to look at cutting many more millions of dollars. Health care programs and services would've been on the chopping block once again, according to Steve Green, president of the California Academy of Family Physicians.
"People didn't want to think about all of the slashing and burning that would take place if Prop. 30 didn't pass," Green said. "It's a tremendous relief, knowing that millions of dollars aren't going to be cut out for the poor again. So not having to cut so much, that will help us focus more on the things that need to happen. When you're in a crisis mode all the time, that makes it much harder to plan for the future."
It has been budget crisis mode throughout the Brown administration, starting with the first budget in January 2011 with health care-related cuts that totaled about $6 billion. Since then, there have been major health-related budget cuts in the May 2011 revise, the 2012 budget and the 2012 revise. In fact, according to Anthony Wright, executive director for Health Access California, you have to go back to 2000 for a year when major health care reductions weren't made in California.
"The last time we had an actual surplus was 2000, and that's back when the vehicle license fee was cut," Wright said. "The year 2000. That's a long time ago."
Lisa Folberg, vice president of medical and regulatory policy at the California Medical Association, said the outlook in January is a welcome change.
"I don't see any huge [health care] cuts happening in January. Certainly the passage of Prop. 30 relieves that pressure," Folberg said. "One of our driving concerns has been that, if it didn't pass, the governor and Legislature would have looked to health care for savings."
The next budget will still have budget reductions, she said, such as savings expected from the duals demonstration project, known as the Coordinated Care Initiative. "Those are savings not fully realized," she said, "since we're still waiting for approval from CMS. I'm not positive CMS will approve the duals program, and that could leave the state vulnerable, if they are suddenly finding this hole."
But the big, multi-billion-dollar health care cuts are unlikely this January because of Prop. 30's passage, she said. "And that feels good to some extent. We have some reason to feel hopeful," she said.
"We have seen a decade of devastation to these programs," she added, "so yes, it's hard to feel happy."