State Budget

Updated 7/7/2020

CPEHN’s 2020 Budget Score Card | Updated June 26, 2020

Final Budget Maintains Funding for Critical Health Care Programs Pending Federal COVID-19 Relief

On June 30, 2020, Governor Newsom signed a 2020-21 state budget that delays Health4All elders indefinitely , but maintains funding for critical health and human services programs, after reaching a compromise with the state Legislature. California is experiencing a $54 billion shortfall due to the economic impacts of COVID-19. The Governor’s May Revise proposal, which was rejected by the Legislature, included billions in reductions to Medi-Cal and public health care programs, including cuts to Medi-Cal eligibility and services, at a time when communities of color are still reeling from the disproportionate impacts of COVID-19.

In response to calls from CPEHN and other advocacy groups, the Legislature negotiated an alternative budget that preserves critical funding for these programs, pending federal COVID-19 relief. If Congress fails to act in September, the state can still move forward with cuts to critical state programs.

Key Highlights

The final 2020-21 state budget:

• Maintains Full Adult Dental Benefits in Medi-Cal including laboratory processed crowns, posterior root canal therapy, periodontal services, and partial dentures, including denture adjustments, repairs, and relines.

• Maintains funds for Community-Based Medi-Cal Enrollment Navigators trusted community messengers who provide culturally and linguistically appropriate outreach and enrollment assistance to low-income communities. Their services are needed now more than ever as California responds to the COVID-19 pandemic.
• Maintains Full funding for the Black Infant Health Program (BIH) which provides additional funds for empowerment-focused group support services and case management to improve the health and social conditions for African-American women and their families ($7.5 million) previously approved as part of the 2019-20 budget.
• Delays Health4All Elders which would have extended full scope Medi-Cal coverage to all low-income eligible adults, regardless of immigration status ($87 million)
• Maintains Mental Health Equity Funding which provides funds for capacity building and technical assistance to support community defined mental health programs to reduce disparities by race, language, age, gender identity, sexual orientation, and disability status. ($8M)
• Moves Forward with Medi-Cal Aged, Blind and Disabled Expansion approved in 2019 aligning the income eligibility for the Medi-Cal Aged and Disabled program (currently at 123% FPL), with the rest of Medi-Cal under the age of 65 (currently at 138% FPL). Without this, over 20,000 low-income seniors and those with disabilities between 123-138% FPL face high Medi-Cal costs.
• Maintains the 2019 Budget Act expansion of Medi-Cal to Postpartum individuals who are receiving health care coverage and who are diagnosed with a maternal mental health condition, for a savings of $34.3 million General Fund in 2020-21.

• Maintains other Optional Benefits in Medi-Cal including audiology, incontinence creams and washes, speech therapy, optician/optical lab, podiatry, acupuncture, optometry, nurse anesthetists services, occupational and physical therapy, pharmacist services, screening, brief intervention and referral to treatments for opioids and other illicit drugs in Medi-Cal, and diabetes prevention program services, for a total General Fund savings of $54.7 million.
• Maintains the Diabetes Prevention Program a Medi-Cal covered benefit that provides beneficiaries with at least 22 peer-coaching sessions over 12 months, provided regardless of weight loss.
• Maintains the Community-Based Adult Services (CBAS) program and Multipurpose Senior Services Program (MSSP) effective January 1, 2021 for a General Fund savings of $106.8 million in 2020-21 and $255.8 million in 2021-22 (full implementation). The effective date for MSSP would be no sooner than July 1, 2020. These proposals are discussed in detail under The Department of Aging.
• Maintains Proposition 56 Supplemental Payments for physician, dental, family health services, developmental screenings, and non-emergency medical transportation, value-based payments, and loan repayments for physicians and dentists
• Maintains funds for the Song-Brown Healthcare Workforce Training Program which provides grants to support primary care residency training programs in California, including family medicine, internal medicine, OB/GYN, and pediatrics with a focus on attracting residents from underrepresented communities and training students to work in underserved areas.
• Delays Cal-AIM for a savings of $347.5 million General Fund. Cal-AIM, a multi-year initiative by DHCS that aims to improve health outcomes for Medi-Cal beneficiaries through implementing broad delivery system, program and payment reform across the Medi-Cal program.

New Trigger Cuts: Additionally, the Budget includes $11.1 billion in reductions and deferrals that will be restored if at least $14 billion in federal funds are received by October 15, 2020. If the state receives a lesser amount between $2 billion and $14 billion, the reductions and deferrals will be partially restored. The trigger includes:

• $6.6 billion in deferred spending on schools
• $970 million in funding for the University of California and the California State University
• $2.8 billion for state employee compensation
• $150 million for courts
• Funding for child support administration, teacher training, moderate-income housing, and infrastructure to support infill housing.
• An additional $250 million for county programs to backfill revenue losses.

Continued Federal and State Advocacy is Needed!
Given the current economic crisis and political impasse in D.C., we must stay vigilant as the Legislature can still come back and make further cuts to the budget this fall should a federal deal on the next COVID-19 stimulus package fall short. CPEHN and our partners are advocating for Congress to pass a relief package that prioritizes COVID-19 emergency funds for health equity. The next package must include additional funds for Medicaid and Tribal Health programs, including oral and mental health, additional funds for a robust COVID-19 public health response including no cost testing and treatment regardless of immigration status, collection of demographic data on COVID-19 morbidity and mortality and grants for CBOs to engage in contact tracing efforts.

At the state level, CPEHN has joined with other state advocates in advocating for the Legislature and Governor to pass additional tax measures this summer as part of the Commit to Equity campaign to help bridge this gap. Ideas under consideration include a tax on the top one percent of taxpayers, increasing taxes on corporations and instituting a wealth tax on billionaires.