Brown’s Budget Sunniest In Years
For the first time in many years, California is moving toward a budget surplus. However, the provider community has raised concerns that they will not escape funding cuts for their services.
Gov. Jerry Brown's $97.7 billion 2013-2014 budget, unveiled late last week, includes not only a $1 billion budget reserve, but a planned gigantic expansion of the Medi-Cal program.
“This budget can invest in education, expand healthcare and provide a safety net for the most vulnerable,” Brown said. His proposals rest on rosier economic projections as the state slowly leaves the worst impacts of the Great Recession behind.
As many as 2 million Californians will be enrolled in Medi-Cal as part of the Patient Protection and Affordable Care Act, although the federal government will pay for virtually all of the expansion for the next several years. Brown has made dual proposals of managing the Medi-Cal program at both the state and county levels, and has dedicated $350 million as a “placeholder” to explore both options in the near-term, according to a report by the Legislative Analyst's Office.
Brown's healthcare proposal also includes a 4.9% increase in funding to the In-Home Supportive Services program, although that will be virtually offset by a 20% decrease in the hours provided to elderly Medi-Cal enrollees by program employees. Budgeting for the state's major healthcare agencies is flat; the California Department of Public Health, for example, would be cut a modest 0.95%. However, funding for public health emergency preparedness would be cut by 8.8%, according to the CDPH.
Moreover, more than $300 million of Brown's planned surplus is coming from fees imposed on California's hospitals that are used to leverage additional federal funding from the Medi-Cal program. The California Hospital Association referred to this fund movement as a “raking off” of funds the lobbying group believes should be spent on Healthy Families or Medi-Cal coverage for children.
“These hospital funds should be used to ensure access to medically necessary hospital services for all Californians,” said CHA President C. Duane Dauner.
Additionally, Brown would like to end the decade-long receivership of California's prison healthcare system, which includes private sector outsourcing and boosting the pay of prison physicians and nurses to some of the highest rates in the nation. How this would impact the state's healthcare providers remains to be seen.
