Even Governor Jerry Brown sees the danger of trusting the federal government to uphold their end of the bargain in the Affordable Care Act:
“The ultimate costs of expanding our healthcare system under the Affordable Care Act are unknown,” he told the Legislature in his January State of the State address. “Ignoring such known unknowns would be folly.”
Democrats — who control both houses of the Legislature — in usual fashion, want to spend now and worry later:
As Democratic lawmakers speed to implement President Obama’s healthcare overhaul in California, they are finding themselves at odds with the leader of their own party: Gov. Jerry Brown.
The governor and legislators disagree over how the state should expand Medicaid to more than 1 million low-income Californians, a critical component of the federal Affordable Care Act.
It seems the Democrats do not see the danger in expanding services under Medical — the states version of Medicaid — while the Governor wants to be more cautious:
Under proposals passed by both houses of the Legislature last week on mostly party-line votes, individuals earning up to 138% of the federal poverty level — or $15,415 a year — would be newly eligible for Medi-Cal, the state’s version of Medicaid.
Concerned about new costs, Brown wants to scale back some of the benefits the Legislature has proposed. Long-term care for the disabled would not be part of the package under the governor’s plan.
Also under Brown’s plan, groups that are now covered by Medi-Cal, including certain AIDS and cancer patients and recent legal immigrants, would be shifted into a state-run insurance exchange where they would receive partial coverage but pay premiums for the first time. Democratic lawmakers want those groups to remain in Medi-Cal.
Brown also wants to reduce the roughly $2 billion the state gives to counties each year to care for the uninsured — whose numbers will fall — to offset new administrative costs.
It will be interesting to see how they resolve their differences in the coming months. The Democrats — always thinking behind, see this as an opportunity to repair holes in the budget from recent years:
Having heeded the governor’s calls to slash billions of dollars in services in recent years to help balance the state budget, the Democrats who dominate the Legislature are pushing back, seeing an opportunity to patch holes in public aid programs. They note that Washington picks up the whole cost of Medi-Cal expansion for the first three years and then phases down to 90%.
But Brown sees danger ahead:
Brown has sounded a note of caution even as he has said he embraces the federal law. Echoing the concerns of Republican lawmakers, he has said the long-term costs of the healthcare expansion could undermine California’s tenuous fiscal stability.
Listen to your inner wisdom, Governor Brown.
The Watercooler is always an open thread.
