Governor Newsom’s Proposed Budget for Health and Human Services
The Governor is proposing $158 billion, of which $40 billion is state General Fund for Health and Human Services programs. This includes Medi-Cal ($100 billion), public health ($3 billion), State Hospitals ($2 billion), Developmental Services ($7.8 billion), realignment funds from the state to counties ($11.5 billion), IHSS ($12.7 billion), SSI ($2.8 billion), CalWorks ($4 billion), and other ($14 billion).
The caseloads are varied: Medi-Cal (13.2 million), CCS (15,000), CalWorks (371 thousand), Cal Fresh or Food Stamps (1.9 million), SSI (1.2 million), IHSS (564 thousand), Regional Centers (350 thousand). The programs with enrollment growth are: Food Stamps, IHSS, Regional Centers and Medi-Cal). Programs with enrollment declines are CalWorks and SSI – both cash assistance programs for low-income families, the aged and disabled – as the economy improves and unemployment stays low.
The Governor proposes to use the state’s negotiating powers to slow the rise in prescription drug prices by making the state the single prudent purchaser for MediCal patients – this means the state negotiates reimbursement rates with all drug manufacturers. This prudent purchaser program could be expanded to all public and private coverage if the legislature and Congress (for Medicare) so approves.
For Covered California, he proposes to increase premium assistance and cost sharing assistance to moderate and middle-income families between 250% and 600% of the federal poverty level. He proposes that the state of California institute the tax penalty for shared responsibility/the individual mandate that Congress repealed last year. These should reduce premiums, increase affordability of coverage and care and increase participation in Covered California. The details are missing.
He proposes to expand MediCal coverage from emergency and maternity care to full scope coverage for low-income undocumented adults between the ages of 19 and 25 – General Fund costs of $197 million. This follows on the successful expansion for children 0-18.
He seeks to build on and complete the job of the ACA and to cover every Californian and then seek federal authority to consolidate the diverse elements of coverage into a single sensible program.
He proposes early treatment of psychosis for young people ($25 million) and better funding of whole person care for those suffering from severe mental illness and chronic homelessness ($100 million).
Medi-Cal spending would increase from $98.5 billion to $100.7 billion ($23 billion General Fund). The budget includes $3.2 billion for provider rate increases. Caseload growth is quite small — about 50,000.
IHSS pays for home care for the severely ill elderly and disabled. Its budget would increase by 15% to $12.7 billion ($4.3 billion General Fund), driven primarily by caseload increases and increased services.
Developmental Services budget is $7.8 billion of which $4.8 billion is General Fund. The budget proposes to close the last three large state operated facilities and transfer the funds from institutional care to community care.
Prepared by: Lucien Wulsin