New! Check out CPEHN’s 2017-18 Budget Scorecard for the current status of state budget negotiations on health and other issues impacting our communities (updated 5/26/17)
Governor's Revised Budget Includes Modest Increases Amidst Continuing Federal Uncertainty
On Thursday, May 11th, Governor Jerry Brown released his $180 billion FY 2017-18 revised budget plan. Despite a budget surplus, the spending plan includes only modest spending increases. The Governor cites ongoing uncertainty over the future of the Affordable Care Act (ACA) and Medicaid as a rationale for his conservative approach. The Governor specifically calls out Republican members of Congress for voting for a GOP repeal plan that would hurt California constituents. “I really don’t understand why those people in swing districts are following the dictates of Donald Trump,” Brown said in a media briefing. “They’re going to have to do penance for it,” he added.
CPEHN applauds the revised plan to scrap a problematic proposal to transfer recent legal immigrants, also referred to as “Newly Qualified Immigrants (NQI),” from Medi-Cal into Covered California. The proposed ‘NQI wrap’ would have burdened low-income immigrants by requiring them to navigate two separate health systems, and the complex Affordable Care Act tax credit reconciliation process during their first years in the United States. It is likely that many would have gone without coverage or needed health services. The May Revision continues the state’s commitment to fully funding the Medi-Cal program, expected to cover 14.3 million Californians, which accounts for over one-third of the state’s population, including undocumented children. The Governor also upheld his promise to protect immigrant populations by bolstering funds for legal services and granting additional resources for the Attorney General to defend California’s values against federal policies, including immigration, health, and the environment.
Despite an increase in voter-approved Proposition 56 (Tobacco Tax) state revenues, the Governor did not include proposals by CPEHN and other consumer advocates to fully restore dental benefits for adults in Medi-Cal and to expand access to Medi-Cal for young adults up to age 26 regardless of immigration status. Instead those funds are proposed to be used to offset costs of the growth in the Medi-Cal program. CPEHN continues to urge the Governor and the Legislature to make these much-needed, modest investments.
Join CPEHN today in urging the full restoration of adult dental benefits in Medi-Cal.
To view the full revised budget proposal, visit the Department of Finance's website. CPEHN will continue to monitor and weigh in on the proposed budget to ensure the Governor is adequately prioritizing the health of our most vulnerable communities.
- Maintains Full Medi-Cal Coverage for Newly Qualified Immigrants: The Administration will no longer pursue implementation of the newly qualified immigrant (NQI) wrap program, which would have endangered health care for certain immigrants by transferring them into an undeveloped and untested program. Instead, the Department of Health Care Services will seek a “minimum essential coverage” designation from the federal government for full-scope state-only Medi-Cal programs to resolve the potential that NQIs receiving coverage through Medi-Cal will be assessed a tax penalty. CPEHN applauds and thanks the Administration for maintaining California’s long history of covering NQIs in Medi-Cal coverage. In order to ensure future Administrations maintain these important protections, we urge the Legislature to memorialize these changes in statute.
- Fails to include funds to expand access to health care for all, including undocumented adults: While we applaud the January budget’s full funding for Health4All Kids, the May Revision budget still includes no new funding to provide health coverage to the over one million undocumented immigrant adults ineligible for Medi-Cal due to immigration status.
- Increased revenues from Tobacco Tax (Proposition 56), but no specific allocations: The California Healthcare, Research and Prevention Tobacco Tax Act of 2016 requires 82% of funds remaining after specified allocations be transferred to the Healthcare Treatment Fund to support new growth in Medi-Cal expenditures. The Governor’s revenue projection for the Proposition 56 tobacco tax increased by $23.3 million in the May Revision, $19.8 million of which is statutorily allocated to the Medi-Cal program. However, the revised budget proposal does not allocate the funds to specific investments to strengthen Medi-Cal. CPEHN continues to urge the Governor and the Legislature to invest a portion of the Proposition 56 revenues to fully restore adult dental benefits, and to expand eligibility for Medi-Cal to undocumented young adults up to age 26.
- Funds data collection tool for children’s mental health: The Budget revision includes $6.2 million GF for the implementation of a functional assessment tool for children receiving specialty mental health services, in order to gather and report data regarding outcomes and quality of county-operated specialty mental health services. The Department of Health Care Services and county specialty mental health plans are currently required to report performance outcome measures for children receiving Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) services. The functional assessment tool is an important component of the Performance Outcome System. CPEHN also strongly supports improving performance, quality, and disparities measures for adult services delivered by county-operated mental health plans, and is sponsoring AB 470 (Arambula) to add these requirements to the current dashboards.
Other Health Programs
- Reimburses counties for costs incurred as a result of CCI discontinuation: The Budget revision continues plans to discontinue the Coordinated Care initiative in 2017-18, but provides $400 million GF (and decreasing amounts in future years) to offset the impact to county safety net programs of this programmatic change. This will help to maintain county social services, mental health, and health programs. As part of the redistribution of funds, the proposal also temporarily redirects vehicle license fee growth funds from the mental health subaccount to In-Home Supportive Services (IHSS).
- Expands legal services for immigrants: The Budget revision includes a $15 million augmentation for the One California grant program at the Department of Social Services and expands the program to fund deportation defense. This program currently provides funding to non-profit providers of immigrant legal services for naturalization, DACA, and other forms of immigration relief. Given the particular threat faced by California’s immigrant communities under the current federal administration, CPEHN strongly supports this investment and the inclusion of deportation defense.
- Updated estimate of $45.6 million in savings from Proposition 47 during the previous year: Proposition 47 passed by voters in 2014, reformed sentencing laws and redirected savings to community programming. These funds are used for K-12 truancy and drop‑out prevention programs, victim services grants, and mental health and substance use disorder treatment services. The January Budget estimated a slightly lower $42.9 million in savings.
Public Health: Tobacco Tax Revenues (Proposition 56)
- Increased Revenues from Tobacco Tax: The May Revision reports an additional $23.3 million from tobacco tax revenues as reported above. As a result of the voter approved tobacco tax increase in 2016, the January Budget included $1.2 billion in revenue from Proposition 56. In public health, the revenues support tobacco and nicotine prevention and reduction programs in K-12 schools as well as dental, law enforcement and tobacco prevention programs.
Transportation and Climate Change
- Implements Recently Passed Transportation Funding Package: In late April this year, the Legislature passed and the Governor signed a ten-year $54 billion transportation funding package. The funding package increased the gas excise tax, diesel tax, and the vehicle license fee, as well as instituting a zero emission vehicle fee. While the revenues go toward $100 million in the Active Transportation Program, the legislation included harmful pollution exemptions for certain industries.
- Provides $6.5 million to fight Trump: In a reflection of the need to stand up to the Trump Administration on multiple fronts, the revised Budget includes $6.5 million and 31 positions at the Department of Justice for legal workload related to federal actions.