Can Gov. Gavin Newsom use Medi-Cal funding to balance California’s budget?

This article was produced by Capital Main It is published here with permission When it was placed before voters last November California s Proposition sounded straightforward enough It would use billions of dollars in taxes collected from robustness insurance plans to increase payments to doctors and others who care for the state s low-income patients In reality Prop approved in a landslide is a remarkably complicated piece of bill Rather than fortify significant components of Medi-Cal it has served so far to expose the fissures among factions of the state s sprawling healthcare care system and to highlight specific of their irritation with Gov Gavin Newsom What it hasn t done is improve access to care for the million Californians of every people in the state who rely on Medi-Cal the state s version of Medicaid in order to see a medical practitioner And it maybe won t do that anytime soon That much became clear last month when Newsom informed his revised budget proposal for the - fiscal year Included was a plan to claw back about billion of Prop money over the next two years to help reduce the state s billion budget deficit Architects of the plan promptly cried foul saying voters had approved making that money an estimated billion to billion a year off-limits to anything but certain designated sectors of Medi-Cal coverage The list includes raising payments to doctors reproductive services like Planned Parenthood mental soundness care ambulance services and hospitals and clinics that care for low-income patients We believe Newsom s proposal to swipe Proposition funds in order to backfill the state s budget is not only a direct violation of state law but also a snub to the millions of California voters who supported this ballot measure last fall announced Carmela Coyle president of the California Hospital Association a powerful industry lobbying group that helped write the proposition At a budget briefing a scarce days after his revised proposal Newsom asserted that the move is absolutely consistent with the the language of the initiative itself convoluted though it is It may come down to the California State Legislature s own final budgeting process or a legal challenge to sort it out And in the meantime Medi-Cal soldiers on with not enough doctors participating and not enough money to pay for the plan s cost California has faced a Medi-Cal double whammy in contemporary years The cost of the plan itself has skyrocketed to a projected billion for - That s because more people enrolled under Affordable Care Act expansions Newsom enlarged the campaign to include residents regardless of their immigration status and says the nonpartisan Legislative Analyst s Office the advent of Prop itself drove up projected costs by several more billion dollars a year At the same time the state s comparatively low reimbursement rates for Medi-Cal services have led to fewer doctors mental healthcare professionals and other providers accepting those patients California often pays Medi-Cal providers only or of what the federal Medicare campaign pays for the same services The consequence way too sparse providers available for the millions who use Medi-Cal a concern that can be deeply felt in rural areas of the state where there is already limited access to care On its face Prop appears to address that directly It says that billions in special-tax money already being paid by MCOs or managed care organizations like Kaiser Permanente or Anthem Blue Cross has to be spent on these increased payments to providers clinics and hospitals In theory paying better rates will encourage more doctors to take on Medi-Cal patients Alas it s nowhere near that simple First the initiative decrees that the MCO tax which began in and has required reauthorization every scant years become permanent starting in The requirements it places on how the money can be spent also means lawmakers couldn t use the revenue to ease the burden of the Medi-Cal effort on the state s general fund as they ve done for years going back well before Newsom took office And the federal cabinet which matches the MCO tax with dollar-for-dollar funding already warned the state in that it could receive less in the years to come a grim advancement with California facing likely budget deficits annually The restrictions of Prop mean that California legislators can t make thoughtful year-to-year adjustments on spending based on financial projections for the state which is exactly what they re elected to do In politics the term for a measure like this is ballot-box regulation It s perhaps no surprise that Newsom while never formally opposing the initiative openly spoke against it in the months leading up to the November referendum This hamstrings our ability to have the kind of flexibility that s required at the moment we re living in the governor stated during a media briefing last summer I haven t come out publicly against it But I m implying a point of view Perhaps you can read between those several a great number of lines This year the governor went efforts further First his administration failed to submit federal paperwork to get the process rolling although a spokesperson for the California Department of Robustness Care Services narrated Capital Main that the state is still on schedule with its proposals to the federal leadership Then came Newsom s revised budget Proposition was the product of months of intense negotiations among physical condition industry powers the California Hospital Association the California Anatomical Association Planned Parenthood and a large number of others that often view one another as competitors for state funding during the budgeting process Its passage was hailed as a boost for Medi-Cal at a time when the need for its services remains acute Their initiative though wasn t a win for everyone It directs that MCO tax money be used to bump payments largely for primary and specialty care family planning mental healthcare services prescription drugs and crisis ambulance services One such organization provider Global Healthcare Response Inc was the second-largest donor to the million Yes on campaign Locality healthcare workers private duty nurses and certain forms of Medi-Cal coverage such as continuous care for eligible children up to age aren t included Now it s uncertain how this process plays out If Newsom s proposal is approved by legislators a substantial chunk of Prop money will be used to loosen the state s budget squeeze and set a precedent for future years That prospect has longtime supporters of the governor publicly protesting To put it just these cuts are plain cruel reported Jodi Hicks CEO of Planned Parenthood Affiliates of California which faced a second blow in Newsom s budget revise when the governor proposed using million earmarked for family planning services to instead help offset the deficit With this budget revision Gov Newsom is effectively defunding Planned Parenthood in the state of California As with the patients of numerous other wellness system organizations in the state Planned Parenthood s overwhelmingly rely on Medi-Cal for their coverage It is a common theme and one thread of a continuously complicated wellbeing care story one that will almost certainly get messier Capital Main is an award-winning nonprofit publication that reports from California on the majority of pressing economic environmental and social issues of our time including economic inequality conditions change fitness care threats to democracy hate and extremism and immigration Copyright Capital Main