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Budget Health Care Bartering Brewing

Let the bargaining begin.

Last week’s budget proposal by Gov. Jerry Brown (D) didn’t restore cuts from previous years — with the exception of the already agreed-upon reversal of a 7% cut in In-Home Supportive Services hours — and that omission was not lost on consumer health advocates.

Health care advocates pointed to several issues not addressed in Brown’s proposed budget, including:

  • Medi-Cal rates: “We are very concerned that the budget does not address California’s outdated and inadequate provider rates when our state already has one of the lowest Medicaid payment rates in the country,” said Wendy Lazarus, co-president of The Children’s Partnership. “We urgently need to incentivize doctors and dentists to participate in the program and serve low-income families.”
  • Immigrant coverage: “We are concerned that this year’s budget does not provide immigrants protected by President Obama’s recent executive order the opportunity to enroll in Medi-Cal,” said Carmela Castellano-Garcia, president and CEO of the California Primary Care Association. “This decision continues a two-tiered health care system and fails to close a big hole in California’s health care safety net.”
  • Dental: “We are disappointed that [the governor’s] budget proposal does not make any attempt to address the access crisis that has resulted from Denti-Cal’s failures,” said Walt Weber, president of the California Dental Association, including Medi-Cal rates and a failure to exempt pediatric dental services from a 10% provider cut, even though most pediatric medical services were exempted.

But this budget was notably different than previous budgets from Brown, said Diana Dooley, secretary of the state Department of Health and Human Services.

“This budget is blessedly a go-forward budget, it’s not a budget with [health care program] reductions,” Dooley said.

This is the fifth budget proposal from the governor while Dooley has been CHHS Secretary, and it’s a relief compared to previous years, she said.  

“This is the easiest one yet,” Dooley said. “The others were so very difficult.”

Among the health-related proposals likely to be raised in the Legislature this year are some kind of reversal of the 10% rate reduction for Medi-Cal providers — possibly a more targeted approach than in previous years — and an attempt to extend coverage to undocumented immigrants.  

Legislative initiatives will be part of the discussion as the budget moves toward completion in May, Dooley said.

“This is a collaborative and cooperative process with our legislative partners,” Dooley said. “It has been hard to balance the budget in the first place, and it’s been hard to keep it balanced. But we will entertain proposals from the Legislature.”

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