Gov. Jerry Brown committed Tuesday to a state-based expansion of subsidized health care for low-income Californians, abandoning a proposal he had floated that would have required each of the state’s 58 counties to provide care for the low-income people in their communities.
But Brown, in his revised budget for the coming year, said he still wants to redirect the lion’s share of the money the state now gives the counties to provide care to the uninsured.
His rationale: the expansion of Medi-Cal under the federal health reform law Jan. 1 will mean that far more people have insurance, and far fewer people end up as the responsibility of the counties. It is only fair, the governor says, to shift the money that has been used to reimburse the counties for the cost of that care.
Brown said he wants to enact the shift over several years, and base it on the counties’ actual cost for providing care to those who remain uninsured. He estimates that the counties will give up $300 million in the first year, $900 million in year two and $1.3 billion in the the third year after the expansion of Medi-Cal takes place.
Brown is also proposing a shift of responsibility for a number of health services, including a state takeover of a program that provides care to children with special health care needs.