Despite budget surplus and evidence that lack of access to dental care results in costly emergency room utilization, Governor Brown deepens cuts to Medi-Cal dental care benefits and perpetuates Arnold Schwarzenegger’s legacy of neglect of the state’s oral health.
Yesterday, Governor Jerry Brown announced his May Revision of the California State Budget, declaring for the first time in decades a multi-year balanced budget. In his brief remarks unveiling the proposal, the Governor highlighted the work to implement the Patient Protection and Affordable Care Act (ACA). But he continues to deny dental care for millions of Californians.
In 2009, budget deficits prompted California lawmakers to eliminate adult Denti-Cal benefits to reduce public spending by nearly $109 million. However for next fiscal year California is expecting a $3 billion surplus. Despite the surplus, Governor Brown’s revision of the State Budget continues cuts to Medi-Cal funds for dental care and worsens Medi-Cal provider rates, which would make it harder for nearly 3 million low-income Californians that rely on Medi-Cal to get the care they need.
To the eyes of many, over the past three years, California has taken a leading role in implementing ACA. Under the ACA, millions of Californians will gain access to affordable coverage beginning in January 2014 through a new health insurance marketplace called Covered California. In addition, more than 1 million low-income Californians will be newly eligible for Medi-Cal under a program expansion that state policymakers have said they will adopt. The federal government will pay 100 percent of the cost of this expansion from 2014 to 2016, gradually reducing the federal share to a still-high 90 percent of the cost by 2020. But Governor Brown’s inaction regarding dental benefits will prevent the State from bringing in the one-to-one federal matching dollars authorized by ACA. Furthermore, his lack of understanding of oral health may result in increased utilization of costly emergency room services for dental care denied to Californians. By continuing the neglect to the oral health federal funding will not come into our state, not helping families get the care they need, not improving our health system, and dampening California’s economic recovery.
The Budget includes provider rate reductions enacted through Chapter 3, Statutes of 2011 (AB 97). These reductions will result in General Fund cuts of $488.4 million in 2013‑14. It also includes decreases for MRMIB (a cut of $143.9 million General Fund from the Budget Act of 2012). This significant decrease is primarily due to the transition of Healthy Families Program beneficiaries to Medi‑Cal.
The expectation is that the California Legislature will pass an adjusted budget on time, by June 15. Thus, the next four weeks are crucial for the implementation of the Affordable Care Act, the future of the Medi-Cal program, the state's commitment to the remaining uninsured, and more.
The Center for Oral Health will continue to provide updates on this topic in the upcoming weeks.