Senate Subcommittee Rejects Schwarzenegger’s Proposed Enrollment Caps on Health Care Programs
The Senate Budget Subcommittee on Health and Human Services on Monday voted to reject enrollment caps on a range of health care programs that Gov. Arnold Schwarzenegger (R) proposed in his fiscal year 2004-2005 budget, the Los Angeles Times reports (Ingram, Los Angeles Times, 3/9). In a series of votes, the Democratic-controlled subcommittee voted against the proposals, which included:
- Limiting enrollment in the state's AIDS Drug Assistance Program at 23,900, the level as of Jan. 1;
- Limiting enrollment in a program that serves adults with genetic diseases at 1,679, the level as of Jan. 1;
- Limiting enrollment in a children's medical services program at 37,600, the level as of Jan. 1;
- Limiting enrollment in Healthy Families at 732,300, the level as of Jan. 1; and
- Limiting enrollment of documented immigrants in Medi-Cal at 909,500, the level as of Jan. 1 (California Healthline, 2/18);
Instead of capping enrollment health care programs to close the $17 million budget shortfall, subcommittee members suggested that the state "do more to collect debts owed to the state and cut down on inefficiency" (Benson/Bluth, Sacramento Bee, 3/9). For example, Senate Budget Committee Chair Wes Chesbro (D-Santa Rosa) said that the state could save $800,000 by improving efficiency in ADAP, including allowing automatic refills of drugs for up to six months, rather than capping the program's enrollment, which would save the state only $550,000 per year (Gledhill, San Francisco Chronicle, 3/9). According to the Bee, the subcommittee also "had sharp criticism" for state services, including the Genetically Handicapped Persons Program, which have "failed to collect millions of dollars in potential rebates from pharmaceutical companies" (Sacramento Bee, 3/9). However, the Department of Health Services "put the rebates in question," saying that they are not guaranteed and are still being negotiated with pharmaceutical companies (Chorneau, AP/Contra Costa Times, 3/9).
Chesbro said that the governor's proposed enrollment caps would "result in far higher costs to taxpayers because waiting-list patients would migrate to Medi-Cal and county hospitals," the Times reports. He added, "You don't save money by making people sicker" (Los Angeles Times, 3/9). He said, "To the extent that it's possible, we need to reduce the cost of providing services, not reduce services" (Sacramento Bee, 3/9). Sen. Tom McClintock (R-Thousand Oaks) said that "arbitrary" enrollment caps would result in inequities among beneficiaries and provide a "ground for injustices," adding that he preferred to establish stricter eligibility requirements. Department of Finance spokesperson H.D. Palmer said that the subcommittee "dealt a blow to the governor's efforts to balance the budget by cutting costs rather than reducing services," according to the Times. Palmer said, "The simple math is the Legislature will have to come up with a like amount of savings to offset what the Senate did today" (Los Angeles Times, 3/9).
Some Democrats have "temporarily abandoned a long-standing demand for higher taxes" to solve the state's budget problems, believing that "there is a chance Schwarzenegger might eventually prefer to raise taxes" than pursue spending cuts to health and welfare programs, the Los Angeles Daily News reports. According to the Daily News, Democrats believe that Schwarzenegger's bipartisan negotiations that put Propositions 57 and 58 on the March ballot and the bipartisan campaign he led to get the measures approved are evidence that the governor "is shaping up as a moderate Republican who might break that resolution." However, the Schwarzenegger administration on Monday "dismissed any speculation" that he might "cave in," according to the Daily News. Palmer said, "The governor continues to be fundamentally opposed to tax increases" (Drucker, Los Angeles Daily News, 3/8).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.