Health Issues Spur Debate Into Final Hours of Budget Negotiations

The Legislature yesterday passed a $108 billion budget and trailer bills on time, about four hours ahead of the Sunday midnight deadline.

That doesn’t mean there was universal accord, at least around health care issues.

The budget advanced several health-related programs, but shelved others. Budget highlights include:

  • Restoration of the $3.9 million Black Infant Health Program;
  • Retention of overtime pay for home health care workers;
  • Rejection of proposal to restore 7% cut in In-Home Supportive Services hours;
  • Rejection of proposal to restore 10% reduction in Medi-Cal reimbursements made in 2011;
  • Rejection of proposal to reinstate Early Mental Health Initiative;
  • Rejection of proposal to reinstate Children’s Dental Disease Prevention Program;
  • Rejection of proposal to include autism therapy as a Medi-Cal benefit: and
  • Rejection of a plan to get matching federal funds from a California Endowment grant to help enroll and renew Medi-Cal beneficiaries. 

The decision not to restore Medi-Cal provider reimbursement rates stirred people up on both sides of the aisle, in both houses.

“The state won high praise for signing so many more people up [under] Medi-Cal expansion,” said Assembly member Marie Waldron (R-Escondido). “And we all know access was already extremely lacking. These low reimbursement rates have made it impossible to find care in Medi-Cal.”

“We have to be honest, the expansion of coverage is for the most part, illusory. I find it harder and harder to find any medical providers who can afford to do this,” said Sen. Mark Wyland (R-Escondido). “At some point … if we want to provide the care, we’re going to have to look at these rates, and frankly not just restore the reductions, but increase them.”

Assembly member Nancy Skinner (D-Berkeley), who presented the legislation in the Assembly, said to wait till next year.

“We will monitor and we need to know the impacts of the rate cuts, and other data necessary to adjust this provider rate issue,” Skinner said. “And then we make it a priority this coming year.”

State officials said they’re awaiting federal guidance on whether applied behavior analysis — known as ABA therapy — for autism will be required to be a Medicaid benefit. California lawmakers decided to wait for federal guidance, rather than make ABA therapy a Medi-Cal benefit now.

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