Gov. Brown: 'Not A Lot Left in Budget' to Cover Undocumented

Gov. Jerry Brown unveiled his $164.7 billion budget proposal Friday and while health figures big, the governor also stopped short of funding some key advocacy goals.

For starters, there's no money set aside in the budget to provide health insurance to undocumented immigrants. The "Health for All Act" was re-introduced in December, after falling short in the legislature last year. But when Brown was asked specifically about covering the undocumented, he said "There's not a lot of money left in the budget. … It's very tight."

Then there are the million undocumented immigrants in California estimated to be eligible for deferred action under President Obama's executive order. Advocates say that these immigrants, once approved for deferred action, become eligible for Medi-Cal, as long as they qualify by income.

Brown isn't so sure, and there's no money in the budget to cover this population for Medi-Cal benefits.

"We were very disappointed that these individuals were not included in the Medi-Cal estimates," said Linda Nguy with the Western Center on Law and Poverty. Immigrants who qualified for President Obama's 2012 order, Deferred Action for Childhood Arrival, (DACA) are eligible for Medi-Cal. California covers many categories of immigrants more generously than federal law requires.

But advocates say they are not deterred. "We will push this year to ensure access to coverage for all Californians, regardless of immigration status," said Anthony Wright, executive director of Health Access in a statement.

Costs of Surging Medi-Cal Enrollment

Medi-Cal enrollment has expanded dramatically under the Affordable Care Act. The budget estimates the caseload to reach 12.2 million people this year up from 7.9 million people in 2012-13, before the ACA went into effect. It is likely that enrollment should stabilize soon. More than two million people signed up last year, the first year of the Affordable Care Act, but the budget proposal estimates only another 300,000 or so people signing up in the 2015-16 budget year.

During his budget presentation Brown said at least three times "California is doing more than other states," to mitigate the effects of poverty. (He may be sounding a bit defensive because his budget does little to restore deep safety-net recession era budget cuts.)

While the federal government is picking up 100 percent of the cost of people who are newly eligible for the program, plenty of other people are signing up who were eligible before, but not enrolled. The federal government only pays 50 percent of the cost of this population; the state pays the rest.

Brown's budget presumes $940 million in state costs for this "previously eligible" population. But there's an offset. Before the implementation of the ACA, the state had sent money to the counties to provide indigent care.

In the budget, the state anticipates saving roughly $700 million in what it had been sending to the counties for both the 2014-15 budget year and the upcoming one. In other words, the net cost for the previously eligible population is about $200 million this year in state dollars.

Most Medi-Cal beneficiaries are now enrolled in a managed care plan. While Medi-Cal enrollment can happen any time, Brown is proposing to institute a 90-day open enrollment period that would be the only time people would be able to change managed care plans. The move would save $1.6 million, and "supports continuity of care."

Other Social Programs

Brown is also proposing ending the 7 percent reduction in in-home supportive services (IHSS) hours.

The state is not budgeting any increase in SSI grants. The federal government will provide a maximum $11 monthly increase for individuals and $16 for families.