So Long, Healthy Families Program

October 24, 2013

Next month, following a 15-year run, the curtain will go down on California’s Healthy Families Program (HFP), which has provided low-cost health, dental, and vision coverage for children in low- and moderate-income families. As part of the 2012-13 state budget deal, lawmakers adopted Governor Brown’s proposal to transfer children enrolled in the HFP to Medi-Cal, California’s largest publicly funded health coverage program for low-income residents. In addition to providing coverage for children transitioning from the HFP, Medi-Cal now covers all newly enrolling children who were previously eligible for Healthy Families, up to 250 percent of the federal poverty line ($48,825 for a family of three in 2013).

The shift of children from Healthy Families to Medi-Cal began this past January 1 — when about 850,000 kids were enrolled in the HFP — and has proceeded in several stages. By the end of September, nearly 730,000 children had been transferred to Medi-Cal, although tens of thousands of children did not make the transition because they lost eligibility for Healthy Families prior to their scheduled transfer date. (Children can be removed from the HFP for a number of reasons, including if their families do not pay monthly premiums or they reach their 19th birthday and “age out” of the program. It’s likely that at least some of these children found — or eventually will find — their way onto Medi-Cal by applying for coverage through their county human services offices.) The final group of children — more than 20,000 — will transfer from Healthy Families to Medi-Cal on November 1.

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Once the transition from Healthy Families is complete, nearly half of all California children will be enrolled in Medi-Cal, according to state estimates. Ultimately, the success of this transition will hinge on whether children in Medi-Cal are able to access the health care services they need. In this regard, state officials have more work to do. For example, many children with autism lost access to critical behavioral health services when they were shifted from Healthy Families to Medi-Cal. Another concern: Doctors, dentists, and other Medi-Cal providers are bracing for — or have already felt the impact of — a 10 percent provider payment cut that the state has begun implementing, although primary care doctors will be largely shielded from this reduction through 2014 due to a provision in the federal Affordable Care Act. It’s too early to tell whether these payment changes will, on balance, have a positive or negative impact — or no impact — on provider participation in Medi-Cal and thus on children’s access to care. State officials should closely monitor the situation in the months ahead to ensure that all of the more than 8 million Californians enrolled in Medi-Cal — children and adults alike — have timely and adequate access to needed care.

— Scott Graves


Triggering Anxiety

July 2, 2012

As we reported last week, the 2012-13 spending plan signed by Governor Brown rests on the key assumption that voters will pass the Governor’s ballot measure in November. The Governor’s initiative would increase personal income tax rates on very-high-income Californians for seven years and boost the sales tax rate by one-quarter cent for four years. These increases – which would primarily affect the top 1 percent – would raise an estimated $8.5 billion in 2011-12 and 2012-13. Of this total, $2.9 billion would go to public schools and community colleges and the remainder – $5.6 billion – would help close the state’s budget gap and avoid the need for deeper spending cuts than have already been made in recent years. The new revenues would help stabilize California’s fiscal situation and create a foundation on which to rebuild going forward.

What happens if voters reject the Governor’s measure? The budget agreement would automatically trigger $6 billion in spending reductions on January 1, 2013. K-12 schools would bear the brunt of these “trigger” cuts – $4.8 billion, or more than 80 percent of the total – with schools authorized to reduce the school year from the current minimum of 175 days of instruction to 160 days of instruction in each of 2012-13 and 2013-14.

Colleges and universities also would face deep midyear cuts if the Governor’s initiative fails. With the stakes this high, the months leading up to the November 6 election are likely to be anxious ones for parents of school-aged children, university students already struggling with rising fees, and jobless Californians who have gone back to school to retool their skills in a tough job market.

— Scott Graves


Statement: The California Budget Project on the 2012-13 State Budget

June 28, 2012

The California Budget Project, a nonpartisan public policy research group, released the following statement from Senior Policy Analyst Scott Graves in response to the budget signed by the Governor last night:

“This budget includes major reductions in a number of critical areas, especially support for families who need child care or help in moving from welfare to work. Still, lawmakers deserve credit for embracing a balanced approach that includes the Governor’s proposal to raise much-needed revenue in order to avoid a cuts-only budget. If voters approve the Governor’s tax initiative in November, California will avoid more deep cuts to schools, colleges, and other building blocks of a strong economy. The new revenues would help stabilize our fiscal situation and create a foundation on which to rebuild going forward.

“While the state’s current budget challenges are partly the result of the Great Recession, they have been made worse by years of tax cuts, including recent corporate tax breaks adopted with little scrutiny. In addition, the two-thirds vote requirement for the Legislature to approve any tax increase has made it nearly impossible to close recent budget gaps without severe cuts. Several years of spending reductions have hit public education, essential services for low-income seniors and people with disabilities, and support for vulnerable families struggling to find or keep jobs in a tough labor market. Additional revenues that put California’s finances on solid footing are needed if we are going to restore the luster to the Golden State.”