Health Programs Face Significant Cuts Under Brown's Budget Plan January 6, 2012 Medicare, News, Public Health 2012-13 budget, budget cut, Governor Brown, Healthy Families 0 Governor Jerry Brown released his proposed 2012-13 budget today, five days before the state constitutional deadline. The budget aims to fill a projected shortfall of $9.2 billion dollars ($4.1 billion in the current budget year and $5.1 billion in 2012-13) and create a $1 billion reserve, for a total of $10.1 billion in “solutions.” The Governor proposes to close the deficit through a combination of $4.1 billion in cuts to public programs coupled with $5.1 billion in new revenues from a proposed tax initiative that will appear on the November 2012 ballot, and approximately $1 billion in borrowing and fund shifts. If the Governor’s tax initiative is unsuccessful, the budget outlines cuts totaling $5.39 billion, which fall primarily on education programs such as Proposition 98 (K-14 spending), the University of California and the California State University. Issues of Concern to Physicians Of concern to physicians, included in the 2012-13 budget proposal are the following: Elimination of the Healthy Families Program and transition of enrollees into Medi-Cal. This proposal, which was debated but not adopted last year, would transition all 900,000 Healthy Families children into Medi-Cal. While the Governor claims that this proposal would “prepare the state for health reform,” federal reform would only move about one-quarter of the children from one program to another. This proposal moves well beyond this, and may have the effect of straining the already-overburdened Medi-Cal delivery system. Estimated savings: $64.4 million (2012-13) and $91.5 million (2013-14) Mandatory enrollment of Medi-Cal/Medicare Dual Eligibles into Medi-Cal Managed Care. Under this proposal, all 1.2 million dual eligibles would be required to join a managed care plan, which would coordinate benefits from both programs. Recently-adopted CMA policy (HOD 203-11) specifically opposes this move, due to concerns about continuity of care and access to specialists. Estimated savings: $678.8 million (2012-13) and $1 billion (2013-14) Medi-Cal Managed Care expansion into rural counties. The Governor proposes to expand the Medi-Cal Managed Care program into rural counties that do not currently have managed care infrastructure. This transition would happen gradually over time. It is unclear whether all rural counties would have the physician networks and health care infrastructure to support managed care. Estimated savings: $2.7 million (2012-13) and $8.8 million (2013-14) The FamilyPACT program, the Every Woman Counts program, and the Prostate Cancer Treatment Program will be moved to Department of Health Care Services (DHCS). Unlike previous years, none of these programs is proposed to be cut, but administration of them will be moved to a new department. Securing operational flexibilities in the Medi-Cal program (benefit design, service delivery, etc.). This proposal is largely undefined, but could include reducing benefits or changing care delivery models. Estimated savings: $75 million (2012-13) Timelines and Next Steps Now that the Governor has released his proposal, the Budget Committees in both houses of the Legislature will begin considering it in the next few weeks. SFMS/CMA will be actively lobbying against reductions to health care programs and will inform members and staff as appropriate. Comments are closed.
