What legislators and stakeholders are saying about Newsom’s “May Revise” proposal

It’s been less than a week since California Governor Gavin Newsom announced the specifics of his “May Revise” budget proposal. Overall the reception to the budget proposal was favorable, but on some issues legislators and stakeholders feel Newsom “missed the mark.”

 

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Ronald Coleman, managing director of policy for the California Pan-Ethnic Health Network (CPEHN), said at a time when California has a budget surplus of $75.7 billion, CPEHN is “extremely disappointed” the governor didn’t take the chance to expand and invest in racial equity in health care and in public health.

“At a time when we have such a huge surplus, and also such a strong stream of funding from the federal government from the American rescue plan. We feel like Governor Newsom certainly missed the mark. We have seen the devastation that has impacted communities of color, not just from Coronavirus — and sickness and death — but also the economic impacts from the pandemic. And at a time when California is positioned to ensure that all communities can thrive, he completely missed the mark on making those needed investments as part of the May Revise proposals.”

Coleman is not the only one disappointed in the governor’s lack of investment in public health. Advocates said without investment to bolster outreach to communities long affected by systemic racism in health care, communities of color will again bear disproportionate injuries from the next public health threat.

Specifically, Dr. Richard Pan, pediatrician and chair of the Senate Committee on Health, said without a robust public health system, the state will continue to experience large losses of life during public health emergencies.

“COVID demonstrated to us again that contagious diseases are more deadly than wars as COVID has killed more Americans in a year than the number of Americans killed in all of World War II. Public health is our defense against disease. Lives are being lost because of public health underfunding. We must rebuild public health in our state and communities by building  and funding a sturdy public health system in California that protects us from future contagions.”

Augustin Rucobo, a senior public health nurse in San Diego County and member of SEIU Local 221, said without a sustainable investment in public health to ensure a strong public health workforce, California’s public health infrastructure will remain weak and vulnerable to the next emergency.

“The devastation of COVID-19 was made worse by decisions to slash public health funding and leave the hard work of health equity undone. Staff burnout, high turnover rates and antiquated equipment slowed public health before COVID-19. In the pandemic, they proved deadly. California must not repeat these devastating mistakes.”

Advocates say they are pushing for the legislature to prioritize $200 million ongoing state General Fund dollars to rebuild local health jurisdictions. Coleman said this money would help fund work on social determinants of health.

“A proposal that would inject funding into local public health departments and community-based organizations so that they can work together, particularly on addressing social determinants of health. That was certainly absent from the proposal. We do believe that there should be a very strong investment in public health and also the community-based organizations who partner with local public health departments. These are the agencies who kept us safe throughout the pandemic and also the community-based organizations that were successful in delivering necessary information to communities, about testing, about treatments and also about vaccines.”

On issues like expanding Medi-Cal coverage for undocumented immigrants, Coleman says the governor did not go far enough, and although the expansion of coverage to undocumented seniors over 60 is a good step, it leaves out a large number of Californians.

“Certainly this proposal is exciting because it does expand Medi-Cal to 90,000 more individuals in the state who desperately need access to quality health care. However, we’ll still have about 1 million undocumented immigrants who are eligible for Medi-Cal, but not able to enjoy the benefits of Medi-Cal specifically excluded because of their immigration status.”

Coleman said they are continuing to work with the legislature to expand access to Medi-Cal, and the ongoing costs of expanding the program to the entire community of undocumented Californians is most likely what stopped the governor from a full expansion. 

The Legislative Analyst’s Office estimated to expand coverage to all of California’s undocumented population, the additional costs would be $790 million in General Fund dollars — $870 million total — in 2021-2022. On an ongoing basis, they estimate additional costs would be $2.1 billion in General Fund money — nearly $2.4 billion total funds.

The California Medical Association (CMA), however, was encouraged by the budget. Dr. Peter N. Bretan, Jr., the president of the CMA issued a statement Friday on the proposal.

“We are encouraged by another state budget that prioritizes health care and expands health care coverage for California residents. As a part of the Governor’s May Revision, CMA commends the Governor for eliminating the threat of suspension of funding for the Proposition 56 supplemental payments. Overall, the May Revision makes important investments and changes in patient coverage and developing the health care workforce California needs to meet current and future challenges.”

However, a spokesperson for the CMA said they were concerned with the governor continuing to promote a policy which reimburses physicians at only 65% for audio-only telehealth. This would essentially amount to a rate cut for physicians providing telehealth care for Medi-Cal patients; as currently full reimbursement for audio-only telehealth through Medi-Cal is available under the emergency COVID-19 regulations.

Legislators and stakeholders as a whole seem to think Newsom had good intentions with his budget proposal, but did not go far enough “to meet the moment.”