Budget Conference Committee Begins Votes on Health Issues

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Budget Conference Committee Begins Votes on Health Issues
06/08/2009

This afternoon the Budget Conference Committee delved into the agenda on health care issues. Some highlights include the following actions (and inactions) by the committee:

Held open the billion dollars in “Medi-Cal Flexibility and Stabilization.” The Legislative Analyst Office (LAO) testified the savings were speculative and unlikely to be achieved, that they didn’t have sufficient information on the savings, and that even if the state could get flexibility from the federal government, it often takes a long time for the Department to implement new changes. The Department of Finance (DOF) testified that they are looking at a number of possible strategies to address the “rate of growth” in the Medi-Cal program and make it “sustainable.” They are having conversations with the federal government about the clawback calculation for drug coverage for dual eligibles, Medicare disability determinations, and the $360 million in California’s hospital waiver to implement mandatory managed care for seniors and persons with disabilities. Chairwoman Evans said she was concerned that this wasn’t specific enough to “take it to the bank” by July 1. The Committee asked for an update and held the item open.

Passed unanimously the proposal to conduct a therapeutic category review of antipsychotic drugs.

Passed a number of drug pricing proposals that limit rates paid by the Medi-Cal program.

Held open freezing reimbursement rates for long-term care facilities.

Rejected (on a party-line vote) eliminating the following state-only programs: breast and cervical treatment and postpartum care for undocumented immigrants, the Dialysis program, the Hyperalimentation program (which provides non-digestive nutrition), and breast and cervical treatment for women over 65 and men. Assemblymember DeLeon argued the committee should flat out reject these cuts and that people will die if they are made. Assemblymember Blumenfield said this is a “bright line moral line that we cannot cross.” Senator Dutton argued that even with all these cuts there will be a lot of health and human service programs remaining and that he could die in a car accident. The one state-only program that was cut unanimously was payment for ancillary services provided in Institutions for Mental Disease (IMD).

Rejected (on a party-line vote) reducing payments for family planning services.

Held open elimination of the Adult Day Health Care (ADHC) Medi-Cal benefit. The LAO testified that if 20% of those persons receiving ADHC benefits shift to long-term care, the state will not realize any savings from the action. DOF admitted thy hadn’t assumed any cost shifts associated with the proposals.

Held open restricting Medi-Cal services for “newly qualified legal immigrants” and PRUCOL individuals to restricted-scope services. Senator Ducheny expressed extreme frustration with the federal government for not covering services for these populations, saying it “shocks my consciousness” that the federal government does this to legal immigrants including 85 year old Vietnamese widows whose husbands assisted the U.S. government. Assemblymember DeLeon agreed that this was a particularly “draconian” cut” which could create a second tier of people.

The committee reconvenes at 10 a.m. on Tuesday, June 9 to continue through the health agenda.