New America Media, Question & Answer, Viji Sundaram, Posted: Jan 12, 2011

Editor’s Note: Health advocates are calling Gov. Jerry Brown’s proposed $12.5 billion permanent cuts to Health and Human Services programs harmful to the health and wellbeing of state residents. By making these drastic cuts, the state will also lose federal matching funds under Medi-Cal, the state’s Medicaid program, and Healthy Families, the state children’s health coverage program. NAM health editor Viji Sundaram asked Anthony Wright, executive director of Health Access, a health care consumer advocacy coalition, to discuss the impact of Brown’s proposals.

Governor Brown proposes to slash $1.7 billion from the state’s Medi-Cal program. About 7.7 million poor Californians, including 1.7 million children, adults with disabilities, the blind and seniors, who are currently enrolled in the program, will be affected by the cuts. What are the impacts of the Medi-Cal cuts?

Wright: Cuts to Medi-Cal would force enrollees to limit doctor/clinic visits to 10 per year, reducing the number of visits Medi-Cal pays for by more than a million. By doing this, the state will save $196.5 million in 2011-2012.

It would also limit prescription drugs to six per month (only life saving drugs will be exempted). The state is expected to save $11.1 million in 2011-2012.

This means that for the sickest 10 percent of patients, their coverage will run out, and they will either no longer go to the doctor or not take prescription drugs—or face significant medical bills.

The budget also proposes to reduce by 10 percent payments to Medi-Cal providers. Even as it is, more than half of the state’s doctors refuse to see Medi-Cal patients because of low reimbursement rates. This will make it even harder to find a doctor.

The cuts will also establish spending limits on medical supplies, wound care, incontinence supplies and such durable medical equipment as wheel chairs and hearing aids.

Other Medi-Cal benefits that would be eliminated are over-the-counter cough and cold medications and nutritional supplements.

What about the Healthy Families program?

Wright: There are cuts proposed in that program as well, which covers nearly one million children of low-income families. The governor has proposed to cut $38.5 million from it.

The proposed budget would increase co-payments and monthly premiums. Additionally, about $11.3 million of the cuts will be achieved by eliminating vision care to children in the program. That will discourage scores of children from going for eye exams, which, in turn, could affect academic performance.

What, if any, impact would the cuts have on seniors?

Wright: About 27,000 seniors who currently receive services at 330 adult day health care centers statewide will no longer have access to services that allow them to continue to live in their homes, rather than end up in a nursing facility. These cuts are expected to save the state $1.5 million in the months remaining of the state budget year, 2010-2011 and $176.6 million in the next fiscal year.

You say the proposed cuts would have other impacts as well. How so?

Wright: Not only will these health cuts have impacts on the health of many Californians, they will impact the financial security of many families, who will have to pay more or find themselves uncovered for needed services.

The cuts will also have an economic impact, since every state dollar we cut means we lose another federal matching dollar or two, money that is needed for our health system and out economy. Cuts of this magnitude mean that tens of thousands of jobs will be lost.

It is appropriate that Governor Brown is putting all solutions on the table, including an extension of existing taxes, to prevent even worse cuts. But that doesn’t diminish the severity of the cuts that this budget proposes.