Brown Seeks To Divert About $2.5B From County Funding
Gov. Jerry Brown seeks to divert about $2.5 billion from counties' indigent care budgets over three years to help expand Medi-Cal, California's Medicaid program, Capitol Weekly reports (Matthews/Howard, Capitol Weekly, 6/5).
Background
Under the Affordable Care Act, a state expansion of Medi-Cal would allow individuals with incomes up to 138% of the federal poverty level, or $15,415 annually, to gain coverage. Medi-Cal is California's Medicaid program.
The federal government will fund the expansion for the first few years, according to the ACA.
Brown has said that the state should try to cover subsequent costs by reducing the amount it provides counties each year to cover health care services for uninsured individuals.
County officials have expressed concern that such proposals to reduce their funding could have a negative effect on their safety-net health care facilities (California Healthline, 3/7).
Details of Proposed Funding Shift
In his revised fiscal year 2013-2014 budget proposal, Brown seeks to divert $300 million from counties in the second half of the 2013-2014 fiscal year, from Jan. 1, 2014 to June 30, 2014.
He also wants to divert:
- $900 million in the 2014-2015 fiscal year; and
- $1.3 billion in the 2015-2016 fiscal year.
Counties Raise Concerns
Although Brown argues that indigent residents will be covered under the Medi-Cal expansion, some county officials do not believe the expansion will affect all of such residents.
Gregg Fishman -- a spokesperson for the California State Association of Counties -- said that asking counties to reallocate funds for indigent care will be challenging because they already are "struggling to take care of the medically indigent now and will have a significant amount of residual uninsured people to take care of even after the [ACA] is implemented."
He said that counties are proposing that the governor allow indigent care funding to continue while the ACA covers 100% of the cost of the Medi-Cal expansion for the first three years.
"Then, after two years, we'll have enough data to say what these (costs) actually are," Fishman said, adding, "[L]et's wait until we know for sure how much savings the counties will realize" (Capitol Weekly, 6/5). This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.