By Daniel Weintraub
Gov. Jerry Brown’s budget proposal calls for deep cuts in health and social service programs that form California’s safety net.
Brown wants to cut $1.7 billion from Medi-Cal, 1.5 billion from CalWorks, and $750 million from the Department of Developmental Services.
Brown would limit access to Medi-Cal services, including prescription drugs, and place stricter time limits on welfare. He also proposes to limit reimbursements for home care for people who need help with daily living so they can remain in their homes and not in an institution.
Although many of the cuts Brown proposed mirror those offered in recent years by former Gov. Arnold Schwarzenegger and rejected by Democrats in the Legislature, Democratic leaders muted their early reaction. Republicans, meanwhile, praised the spending cuts but attacked the part of Brown’s proposal that would ask the voters to extend billions of dollars in temporary tax increases for another five years.
Without those taxes, the cuts Brown proposed Monday would have to dig twice as deep.
Brown’s Medi-Cal cuts would affect millions of low-income families and people with disabilities. He would limit doctor and clinic visits to 10 per year, limit non-life-saving drugs to six prescriptions per month, and set dollar caps on medical supplies, including wheelchairs, hearing aids, wound care and incontinence supplies.
The governor’s proposal would also charge Medi-Cal patients $100 a day, with a $200 maximum, for hospital stays, a $50 copayment for ER visits and $5 co-pays for trips to a doctor, clinic, dentist or to a pharmacy to fill a prescription.
Brown also proposes to reduce reimbursements to doctors, clinics and hospitals by 10 percent, even though California’s rates already are among the lowest in the country and the change would probably mean even fewer doctors would take Medi-Cal patients.
Finally, Brown’s budget would eliminate adult day care health benefits for 27,000 patients.
In Healthy Families, the subsidized insurance program for low-income working families, Brown proposes to increase monthly premiums by 75 percent for families with incomes between 200 and 250 percent of the federal poverty level and nearly double them for families between 150 percent and 200 percent of the poverty level. These increases would affect more than a half million California children. He would also raise ER co-pays and fees for hospital visits while eliminating vision care for children.
Brown is proposing to reduce welfare grants by 13 percent for a family of three — to $604 per month — and limit a full family’s time on aid to four years, rather than the current five years. Grants for the children only would continue beyond that time frame in many cases. He would also cut grants for aged, blind and disabled couples to the federal minimum.
Brown’s budget would also hit in-home care for the elderly and disabled. He would cut reimbursements by 8 percent across the board and eliminate funding for domestic services, such as housecleaning, shopping and laundry, for recipients who live with their caregiver, typically an adult child. In many cases these families say eliminating such reimbursement would force the relative to enter the private workforce, leaving the disabled person without care or requiring them to get it through the in-home program, potentially costing the state even more.