By Kristen HwangCalMatters
This story was initially revealed by CalMatters. Enroll for his or her newsletters.
Six months after California voters overwhelmingly authorized a poll initiative that will increase the pay of docs treating Medi-Cal sufferers, Gov. Gavin Newsom needs to divert that cash to cowl different well being prices.
Newsom final week proposed utilizing $1.6 billion generated by Proposition 35 over the following two years to assist tackle California’s $12 billion state deficit. The governor stated the spending plan is allowable beneath the poll measure, whereas docs, hospitals, clinics and others who help the measure are crying foul.
Rising prices are making Medi-Cal, the state’s medical insurance for low-income folks, unsustainable, triggering an issue over use of funds that voters earmarked for particular well being prices, equivalent to physician’s pay and girls’s reproductive well being.
Along with reallocating the Prop. 35 funds, the governor additionally needs to maneuver $500 million from the state tobacco tax into the state’s common fund. That cash, which voters authorized in a 2016 poll measure, is meant to help household planning and girls’s well being care, amongst different companies.
Well being advocates say the governor’s proposals for shifting the cash will weaken the state’s well being security web and hamstring reproductive well being care.
Deliberate Parenthood stated the double hit from Newsom’s Prop. 35 and tobacco tax proposals within the state funds may cripple its companies.
Jodi Hicks, chief govt of Deliberate Parenthood Associates of California and co-chair of the Sure on Prop. 35 marketing campaign, referred to as Newsom’s proposal “shocking” and “plain cruel.” She stated Deliberate Parenthood would lose a 3rd of its funds whether it is authorized by the Legislature subsequent month. Low-income sufferers must deal with longer wait occasions, fewer appointment choices and probably have to drive additional to entry care.
“Our footprint is so large in sexual and reproductive health care in California. There is no way for other clinics to absorb that,” Hicks stated.
Newsom’s proposal comes at a time when the Republican-led Congress is considering deep cuts to Medicaid. Included is chopping off all federal funding for Deliberate Parenthood. (Medi-Cal is California’s identify for Medicaid.) “We need the state to help us prepare, not make things significantly worse,” Hicks stated.
“Our footprint is so giant in sexual and reproductive well being care in California. There isn’t any manner for different clinics to soak up that.”
Jodi Hicks, Deliberate Parenthood Associates of California
The usage of state well being funds will doubtless be a centerpiece because the state Legislature negotiates a funds cope with Newsom over the following month. A remaining funds is due June 15.
The state’s Democratic lawmakers, who’ve a supermajority within the Legislature, have largely balked at Newsom’s modifications to Medi-Cal, which additionally embrace freezing new enrollment for many adults with out everlasting authorized standing.
“I’m disheartened that the Governor’s updated budget is riddled with deep cuts to our constituents’ healthcare. We cannot boast about having the fourth-largest economy while balancing our budget on the back of everyday Californians’ healthcare,” Meeting Well being Committee Chair Mia Bonta, a Democrat from Oakland, stated in a press release.
Is it authorized to maneuver Prop. 35 funds?
Prop. 35, authorized by 68% of California voters in November, was designed to ensure docs would receives a commission extra to serve sufferers lined by Medi-Cal. Reimbursement charges for Medi-Cal are so low that sufferers usually battle to seek out docs who will settle for their insurance coverage.
Prop. 35 makes use of a particular tax paid by medical insurance plans to generate income for Medi-Cal. Many of the cash — $9 billion in 2024-25 — goes to the state’s common fund. However the extra $1.6 billion that Newsom needs to take for common Medi-Cal spending was purported to be reserved to extend the quantity docs receives a commission for particular companies, equivalent to major care, specialty care and emergency room visits.
Newsom’s funds proposal would as an alternative use the $1.6 billion supposed for docs’ pay will increase to help increased Medi-Cal spending for major care, specialty care, ambulances and hospital outpatient procedures.
Deliberate Parenthood and the California Medical Affiliation helped lead the business group that put the measure on the poll.
In a press release, Dr. Shannon Udovic-Fixed, president of the medical affiliation, referred to as Newsom’s funds proposal a “direct violation of the will of California voters.”
“The proposition was passed to prevent exactly this kind of maneuver – raiding health care funding to solve budget problems,” she stated.
“The proposition was handed to stop precisely this type of maneuver – raiding well being care funding to resolve funds issues.”
DR. SHANNON UDOVIC-CONSTANT, CALIFORNIA MEDICAL ASSN.
When questioned concerning the transfer throughout a funds presentation on Wednesday, Newsom denied this characterization and stated the proposed spending is “absolutely consistent” with the foundations established by the poll measure.
Newsom repeatedly blamed Prop. 35 for inflicting a part of the state’s funds shortfall and referred to as it and different current poll measures “unfunded initiatives.”
The governor stated Medi-Cal has a progress drawback that the state can’t afford.
State spending on Medi-Cal has greater than doubled since 2017 and is now projected to price $76.8 billion within the 2024-25 funds yr. Earlier this yr lawmakers authorized an additional $6 billion for sudden Medi-Cal prices.
The governor stated Medi-Cal has a progress drawback that the state can’t afford. State spending on Medi-Cal has greater than doubled since 2017 and is now projected to price $76.8 billion.
Linnea Koopmans, chief govt of the Native Well being Plans of California and chair of the Prop. 35 advisory committee, stated in a press release to CalMatters that Newsom’s funds doesn’t mirror California’s values.
“Undoubtedly, the state budget challenge is real, but sweeping more than $1 billion of (Prop. 35) revenue is not an option. These funds must be used to support Medi-Cal investments in providers and workforce that are necessary to improve access to care,” Koopmans stated.
The Prop. 35 advisory committee was established by the poll initiative to supervise how the state spends the cash.
Trade supporters of the measure say Newsom’s proposal doesn’t truly pay docs extra; it conflates elevated prices related to Medi-Cal’s rising enrollment with fee.
Molly Weedn, a spokesperson for the Sure on 35 marketing campaign, stated in a press release that the funds proposal raises “serious legal concerns.”
“The Governor proposes using Prop. 35 funding to cover already incurred costs in Medi-Cal and not for increasing provider payments to increase access to health care,” Weedn stated.
Essentially the most contentious a part of the controversy comes down as to if he’s utilizing the Prop. 35 cash to pay the state’s common bills, not simply well being care.
The Newsom administration’s finance division stated in a doc shared with CalMatters that docs’ pay is reviewed and elevated yearly, which aligns with Prop. 35’s necessities. The division additionally denies that utilizing the cash to pay for Medi-Cal would change common fund spending as a result of the quantity that the state is taking from the overall fund for Medi-Cal continues to develop.
Critics say these normal changes are usually not essentially a real price enhance for docs — they principally mirror elevated Medi-Cal prices on account of extra sufferers enrolling or dearer care being supplied. With a view to considerably enhance how a lot docs receives a commission, the state must submit an software for federal approvalwhich it has not achieved.
“It appears the caseload growth in Medi-Cal is being used to justify the need for these funds,” stated Jennifer Kent, an advisor to the Prop. 35 marketing campaign and former director of the well being care companies division.
Newsom isn’t the primary governor to comb cash authorized by voters into the overall fund, and his funds proposal additionally mirrors a transfer made by his predecessor, Jerry Brown, in 2017 to eradicate funds made for household planningladies’s well being and dentistry by the state tobacco tax.
Amy Moy, co-chief govt of Important Entry Well being, which gives grants to clinics for reproductive well being care, stated the governor’s proposed cuts jeopardize California’s dedication to creating abortion, contraceptives and different reproductive well being companies accessible.
Moy, a member of the Proposition 35 stakeholder advisory committee, stated she is assured the ultimate funds authorized by the Legislature will pull again a few of Newsom’s proposed cuts.
“Ultimately we believe that California’s commitment, including our administration’s commitment, to sexual and reproductive health will be reflected in the final budget.”
Supported by the California Well being Care Basis (CHCF), which works to make sure that folks have entry to the care they want, after they want it, at a worth they will afford. Go to www.chcf.org to be taught extra.
This text was initially revealed on CalMatters and was republished beneath the Inventive Commons Attribution-NonCommercial-NoDerivatives license.
