Issue:  Vol. 48 / No. 8 / 22 February 2018

Gov. addresses health care expansion


Governor Jerry Brown (Photo: Lydia Gonzales)
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In the budget he recently proposed for the coming fiscal year, California Governor Jerry Brown addresses expanding coverage for low-income people, but it's not clear how officials will do that.

Medi-Cal, the state's Medicaid health care program for low-income families, currently serves one out of every five Californians, including many people who are living with HIV and AIDS. The program receives 20 percent of the state's general fund, and that figure will increase as the state implements its commitment to federal health care reform under the Affordable Care Act.

In his proposed budget, the governor offers two options for expanding Medi-Cal, Courtney Mulhern-Pearson, director of state and local affairs for the San Francisco AIDS Foundation, pointed out in an interview with SFAF's Bulletin for Experimental Treatment for AIDS newsletter.

One option "would build on the existing state-administered program and managed-care delivery system," Mulhern-Pearson said. The other would build on counties' low-income health programs.

Anne Donnelly, director of health care policy for Project Inform, told the Bay Area Reporter that advocates feel that they understand the state-based option "pretty well," but they have less understanding of the county-based route. One concern is what systems would be used to deliver benefits.

"You want to get as much consistency as you can so people aren't completely confused," Donnelly said.

Another area of interest for people living with HIV and AIDS is the AIDS Drug Assistance Program. That program, often referred to as ADAP, provides people who are uninsured or under-insured and living with HIV and AIDS access to medication.

Last January, the program began moving eligible clients to the counties' low-income health programs. Expenditures are projected to decrease, primarily due to people moving to those programs.

In a message to the Legislature January 10, the day he released his proposal, Brown said the state "is poised to achieve something that has eluded us for more than a decade – a budget that lives within its means, now and for many years to come."

"Absent changes, the 2013-14 budget is projected to be balanced," according to the governor's budget summary. However, there's no adequate reserve, and the state still has billions of dollars in debt. The budget includes a proposal for a $1 billion reserve.

Overall general fund spending is expected to grow from $93 billion this year to $97.7 billion next year. Most of the growth is in health care and education.

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