At the unveiling of his revised $183 billion budget proposal on Thursday, California Gov. Jerry Brown pointed to a chart showing that nearly $125 billion dollars in federal health care dollars would disappear over the course of a decade if Republicans dismantle the Affordable Care Act as proposed.
“That’s a lot of red,” said Brown, describing potential future cuts as “ugly.”
The GOP’s proposed American Health Care Act would substantially cut Medi-Cal, the state’s version of Medicaid and one of its biggest budget items. Although the budget suggests California’s financial reserves could be used to help offset such cuts, Brown vowed to try to prevent Congress from pulling federal funding for the health program in the first place.
“What we’re going to do is fight it as hard as we can so that doesn’t happen,” Brown said.
The Brown administration says if the American Health Care Act is signed into law, the state could lose $5.4 billion starting in 2019, and that loss could grow to almost $24 billion in 2026.
Although Brown’s new spending plan takes into account the state’s potentially bleaker funding prospects, it makes no major changes to state health programs for now. And it reflects a small new pot of money — $44.7 million from the federal government — for addiction treatment programs to fight the opioid epidemic.
Consumer advocates say they agree with the governor about fighting potential federal cuts to Medi-Cal. But they argue his proposal misses an opportunity to use some of the $1.2 billion of new tobacco tax revenue approved by voters in November to improve the current health care system.
Health Access California says the tobacco tax revenue could be used to fully restore previously cut dental and podiatry benefits in Medi-Cal or to expand the program to undocumented adult immigrants up to age 26. Medi-Cal currently covers all children regardless of immigration status.
The governor’s January proposal says the tobacco money will generally be used “to support new growth” in Medi-Cal, which critics say amounts to supplanting existing Medi-Cal dollars.
“The voters were very clear that they wanted [that money] to expand access,” to health care, said Rachel Linn-Gish, director of communications for Health Access.
The California Academy of Family Physicians (CAFP) wasn’t happy that the revised budget continues the January proposal’s planned cut of more than $33 million next fiscal year for physician training. The money is intended to ease the shortage of health care providers in rural and low-income regions.
“With several primary care training programs at risk of closure, now is not the time to reverse that agreement,” said Dr. Michelle Quiogue, president of CAFP.
Brown and high-level health officials said they wouldn’t speculate on how the more than 14 million Californians covered by Medi-Cal would be affected if Obamacare is repealed and replaced. A Congressional Budget Office analysis of an earlier version of the American Health Care Act found that federal Medicaid spending would be cut by $880 billion over 10 years.
“We gotta fight it,” Brown said. “If we’re not successful, then we have to talk about it.”