In today’s 4th of 7 hearings on the Health and Human Services Budget, the Assembly Subcommittee heard specifics of proposals to make reductions in Healthy Families, Medi-Cal, and Adult Day Health Care, among other things. A packed hearing room shared compelling personal stories about how these programs sustain life, and conversely how they or their family members might die or suffer greatly if proposed cuts are enacted.
The testimony was received by sympathetic Assembly members, who asked numerous questions to try to determine the true cost of cutting vital programs. In many of these cases, savings projections did not consider indirect costs such as cost shifts that may end up costing the state more money, such as moving seniors from Adult Day Health Centers to nursing homes and limiting access to preventive and primary care, which may lead to more expensive hospital care.
In considering the elimination of vision services in the Healthy Kids program, advocates pointed out that vision services are crucial to academic success, as 80% of what children learn is learned visually and 1 out of every 4 children need vision correction. The subcommittee expressed interest in hearing a plan that VSP, the provider of vision services to a majority of Healthy Families beneficiaries, is working on to reduce costs while still saving the program.
In the discussion of levying co-pays in the Healthy Families program, members probed staff on whether the savings projections took into account the costs to the state to track payments of co-pays and the resources that would be required to collect. Additionally, we believe that the proposed co-pays violate the federal limit on cost sharing. But of course, the immeasurable cost of placing financial barriers to access to children’s health care is that
Also proposed were cuts to Healthy Families funding, cuts that are to be passed on to the consumers in the form of premium increases. Another increase in Healthy Families premiums will likely make it difficult for many families to continue to participate in the program. However, there is strong reason to question the legality of this cut as it likely violates the Maintenance of Effort requirements for states to maintain eligibility levels.
Proposed cuts to the Adult Medi-Cal program were even more brutal, with hard caps on doctor and clinic visits as well as prescription drugs. The committee members heard testimony from real Californians who feared they would end up hospitalized or institutionalized if they weren’t able to access their regular medical care and prescription drugs. All of these alternatives would mean higher costs to the state which were not included in the estimated savings presented by the Administration. The proposal is also unclear as to how physicians and clinics would be expected to keep track of whether patients were approaching or had exceeded their hard caps. Members of the committee seemed to understand the inevitability of morbidity related to these cuts and asked for the Department to provide projections on how many people would die as a result of these restrictions.
Finally, the committee heard the proposal to eliminate Adult Day Health Care Services, a proposal that has been defeated several times before. Scores of seniors, family members, and service providers testified to the devastating effect that closing ADHC would have on its clients, who would no longer be able to live independent dignified lives. Staff acknowledged that elimination of the program would likely be challenged legally due to potential violations of the Americans with Disabilities Act, and that they did not include in the projected savings, the costs the state to provide alternative services to these frail elderly, or the costs that might be incurred as a result of the impact closing these centers would have on families.
Today’s hearing put real faces behind the outcry that these cuts will cost lives. Members of the budget subcommittee recognized the gravity of the situation and demonstrated commitment to hearing the whole story and looking at budget proposals in the context of the lives of