As a result of this budget, hundreds of thousands of Californians will get more help to access and afford health coverage, preventing premium increases for everyone and benefiting the health system we all rely on.
This budget deal builds on some of the Governor’s first-in-the-nation proposals with important next steps to a more affordable and universal health system. Many Californians will get more help with health care costs and coverage under this budget.
Beyond the Governor’s May Revise budget, health highlights that were sought by health and consumer advocates include:
- Additional affordability assistance in Covered California beyond the revenue raised by a new state-level individual mandate, for around those under 138% of the poverty level (below around $16,800/year for an individual, benefiting around 35,000 Californians), and especially middle-income Californians between 400-600% of the poverty level ($48,000-$72,000/year for an individual, benefiting around 190,000 Californians).
- The end of the “senior penalty” in Medi-Cal, raising the eligibility level for seniors and people with disabilities up to 138% of the poverty level, aligning with the rest of the Medi-Cal program.
- The restoration of several Medi-Cal benefits, including optical, audiology, speech therapy, podiatry, and incontinence creams and washes, which were cut a decade ago during the Great Recession.
- Funding for outreach and enrollment in Medi-Cal, and
- An agreement to extend the Managed Care Organization (MCO) tax, although no revenues were allocated until federal approval.
Breaking new ground nationally, low- and middle-income Californians will get more help affording insurance through Covered California. A state-level individual mandate, paired with additional affordability assistance, will keep people covered and help lower premiums. This vital help for families to afford coverage will go beyond the revenue raised by re-instituting this key part of the ACA here in California. These new state subsidies make a real, tangible difference for those around or below poverty, and especially for those middle-income Californians who now don’t get any help under the federal law, despite the urgent need in our high-cost state. The ACA provides affordability assistance for folks up to four times the poverty level, but with this deal Covered California will now be the first to provide some subsidy to those up to six times the poverty level. This is a big deal to not just defray the high cost of health premiums, but to bring more Californians into coverage.
This budget improves Medi-Cal in multiple ways, including improving access and benefits for the 13 million Californians who depend on the crucial program, while also removing unfair exclusions from full Medi-Cal coverage for seniors and people with disabilities, undocumented young adults, and others. And, after a decade since they were cut in a recession, this budget finally restores key benefits like podiatry, audiology, and speech therapy.
Health and immigrant advocates are pleased that a key provision that we have sought for years will become a reality in California – expanding Medi-Cal coverage to not just all income-eligible children but young adults up to age 26 as well. While a handful of states cover all income-eligible children and pregnant women, California will become the first state to remove the exclusion for other adults, recognizing our health system is stronger when more people can get primary and preventive care. As we cheer this first-in-the-nation step, we were nonetheless disappointed as we were unable to make that same commitment to all California’s undocumented seniors this year.
Health Access’ push to include undocumented seniors, and ultimately to the goal of #Health4All, will continue in the months ahead. Additionally, we will continue to pursue steps in the near-term to achieve the Governor’s and Legislature’s shared goal of getting to universal coverage in the next few years, with greater affordability assistance in Covered California and further expansions of Medi-Cal.
Since 2017, the over 70 consumer and community groups of the #Care4AllCA campaign have advocated to take additional steps to move California towards universal coverage, including the investments needed to close the remaining gaps in our system. The campaign is proud to have successfully argued for more help in affordability assistance up and down the income spectrum, and those impacted by the “senior penalty” in Medi-Cal.