Sen. Mitchell and Janus Norman discuss budget priorities heading into 2021

Sen. Holly Mitchell, Chair of the Senate Committee on Budget and Fiscal Review, and Janus Norman, Senior Vice President at the California Medical Association, laid out their vision for what California’s state budget may look like in a post COVID-19 world during the 2020 NorCal State of Reform Virtual Health Policy Conference last week.

The comments came during a panel discussion titled “Reviewing the evolving budget situation” which also featured Micah Weinberg, CEO of California Forward.



Looking ahead to budget decisions in 2021, Norman says sustaining or growing the state’s investment in the Med-Cal program is critically important – particularly during the COVID pandemic for newly-unemployed individuals.

Another budget priority, says Norman, is the continued investment, expansion, and utilization of telehealth and telehealth services.

“It’s just critically important. It’s vitally important especially when you talk about specialty care in addition to primary care, and mental health services. All of those things – especially when you get out into those areas that have severe shortages of particular practitioners of a particular specialty – telehealth is the remedy that can get those services from one place of the state to the other place in the state in a very cost effective manner,” said Norman.

Norman also discussed the future of the proposed Office of Health Care Affordability which was introduced in Gov. Newsom’s January budget prior to COVID-19. The Office would be charged with looking at ways to lower the cost of care in California and increase transparency. Norman says the Office would take lessons from other states to see what could work for California and would evaluate payment structures for ways to improve health outcomes.

“There does need to be a state investment in providing that level of oversight and ensuring that the state has good access to data, because the state actually doesn’t have the data that it needs in order to track health care spending, health care outcomes and then apply that to the different policies that they are considering in real time,” explained Norman.

Norman says he’s optimistic about the future of the Office of Health Care Affordability. He says the governor’s decision to defer the Office in his May Revise was “a pause and not a delete.”

When it comes to what comes next in the budget discussion, Sen. Mitchell says, first and foremost, she is looking for support from the federal government.

“Every level of the government must come in and consider itself a partner in figuring out how we help California residents weather this unprecedented public health and economic pandemic,” said Mitchell.

She says health care and the safety net were protected during this year’s budget decisions with the expectation that the federal government would come in with a backfill of $14 billion. Mitchell says she fully expects that the additional funding will come, but if it doesn’t the state will need to go back into its “Budgeting 101 toolkit” to figure out how to close the budget hole.

She also points to lessons learned by the Legislature during the Great Recession when the state made deep cuts to public services.

“When people are hurting, as they are now in the middle of a recession, that is not the time for government to contract. That is the worst possible time for us to limit access and eligibility for Medi-Cal, to reduce CalWORKS payments, to retract on any and all state-level supports,” said Mitchell. “That’s when residents need it the most.”

Ending on a more positive note, Mitchell in her closing remarks stressed that the state has been in tough financial situations before and that California will get through it.

“The budget will be tough. It won’t be the worst deficit we’ve ever seen. It will be different…But, we are in a stronger position today than we were 10 years ago in the middle of the Great Recession.”