-         $1 billion in unspecified cuts to Medi-Cal. We have been advised by administration officials that they have a laundry list of possible approaches to achieve these savings including rolling back eligibility expansions and improvements made in 2000. We assume that to mean they would cut eligibility for poor working families, cut eligibility for poor seniors and people with disabilities and require people on Medi-Cal to renew their coverage four times times per year. Collectively these proposals would result in almost a million poor Californians losing their health coverage. And, under the federal stimulus law which conditions receipt of funds on states not cutting Medicaid eligiblity, these proposals would risk the loss of billions of federal Medicaid dollars or require an act of Congress. Of course during this recession with record numbers of people losing their jobs and their health insurance, now is exactly the wrong time to throw more people into the ranks of the uninsured.

 

-         Cut to Medi-Cal benefits for legal immigrants from full scope to emergency services. California decided in 1996 to continue providing full-scope Medi-Cal for legal immigrants and we should continue to do so to meet their individual health care needs and the community’s public health.

 

-         Proposal to eliminate the Healthy Families program. Know that this cut will impact low-income children and would result in almost one million children losing coverage. Consider the 6 year old child in a family of three whose family income is $1527 ($18.324/year) – one dollar more than the poverty level. Today she would receive Healthy Families and pay a premium as low as $4 per month. If Healthy Families is eliminated, she might qualify for Medi-Cal if she meets all the Medi-Cal requirements but she would have a monthly Share of Cost of $593 each month she uses Medi-Cal. This is 39% of monthly income and plainly unaffordable for a family living a hair’s breath above the poverty line.

 

-         Medi-Cal Mental Health Services. We have the least information about this cut, but are very concerned about the proposal to eliminate most outpatient mental health benefits for adults on Medi-Cal – except hospitalizations and prescription drug coverage. Without rehab services and targeted case management services for this population the state will see increased costs for hospitalization, institutionalization, incarceration and homelessness. There is also a proposal to cut certain EPSDT services for children. EPSDT services are required under federal law so we are unclear what services are proposed for elimination.

 

The committee is rightly asking for information for each of the proposed cuts about federal dollars lost, increased costs to the state, and the number of people affected. We urge you to continue to ask those questions to do your best to ensure that while solving the current budget imbalance, we don’t increase state costs and further weaken our vulnerable economy while also causing incalculable human suffering. People’s lives are at stake.