Statement on Governor Brown’s 2011-12 January Budget Proposal
By Howard Kahn, CEO of L.A. Care Health Plan
On January 10, 2011, California Governor Jerry Brown unveiled his 2011-12 Budget proposal, which includes $1.7 billion in cuts to the Medi-Cal program and $39 million in cuts to the Healthy Families program. These proposed cuts will decrease access to health care services for our County’s most vulnerable and low-income residents.
We recognize the serious fiscal situation of the State and the need for shared pain. We also recognize that the Governor and Legislature have very limited options in this environment. However, we feel that the cuts to health care, coming after years of similar cuts, are potentially devastating and the impact needs to be fully examined.
Medi-Cal Cuts
As the nation’s largest public health plan, we are deeply concerned about the proposed 10% provider rate cuts, as California’s rates are already among the lowest in the nation. L.A. Care has always been a strong supporter of safety net providers because they serve our County’s most vulnerable populations. Reducing provider payments by 10% would further reduce access to care, as many health care providers may not be able to care for Medi-Cal patients due to the lowered reimbursement rates. And the vicious cycle would continue: limited access to health care providers would further burden our already stretched health care safety net – especially our emergency rooms.
With the State transitioning seniors and persons with disabilities into Medi-Cal managed care under the Section 1115 Waiver, now is not the time to cut provider rates. We need to ensure that this very vulnerable population has the access to care that it needs. We will not be able to achieve the State’s ambitious anticipated savings without robust provider networks.
In addition, we do not support limiting seniors and persons with disabilities to 10 doctor visits a year. While this population will benefit from the care and disease management that Medi-Cal managed care offers, because many beneficiaries have multiple chronic conditions, limiting their doctor visits is not advisable. In addition to raising concerns about quality of care, this arbitrary limit could cause a percentage of this population to use the ER, at a much higher cost of care than if they were able to see their regular doctor.
We support continuing the hospital fee program. This program, which was agreed to and supported by the hospitals, brings $2.65 billion of much needed funding to the State.
Healthy Families Cuts
In order to continue the Healthy Families program, we support the managed care plan tax, which has proven to be an effective funding stream for the health care of thousands of children in California over the past year.
However, we believe eliminating the vision benefit for children in the Healthy Families program is a bad idea. Studies show that for children, catching vision problems while they are young is important in order to prevent more serious problems in the future. In addition, correcting and fixing vision problems early help children learn in school. We think that children deserve and need comprehensive health care services, which include medical, dental and vision care in order to grow up healthy.
County Realignment Plan
We are very concerned about the Governor’s realignment plan. Currently, the Governor’s plan depends on voter approval of a tax extension package which, if approved, would provide revenue for only five years. For realignment to work there needs to be a dedicated funding source for the long term, along with appropriate local control and administrative flexibility.
We understand that in order to achieve fiscal stability, California needs to make difficult decisions. However, the proposed cuts will eliminate services for the most vulnerable of our residents. We hope that in the coming months, the Governor, the Legislature, and the counties can engage in a productive budget process that we can all support, knowing that it will get our State back on track to a healthy future.