Four big ways California would be affected by the Senate and House Republican healthcare plans
Both bills would mean California would have to foot a bill amounting to billions.
MARCH 22, 2017
The Senate and House bills would shift billions in costs onto California
The Senate bill would shift $3 billion in costs to California's state government in 2020 and increase to $30.4 billion by 2027, according to analysis by the California Department of Health Care Services. DHCS estimated the House proposal would result in transferring nearly $6 billion in costs to California in 2020 to $24.3 billion by 2027.
Annual added healthcare costs that would shift to California
Annual added healthcare costs that would shift to California
The decades-old Medicaid funding structure would change
California embarked on one of the most aggressive implementations of Medicaid expansion under the Affordable Care Act (also known as Obamacare). The expansion resulted in 4 million more people to Medi-Cal, the state's version of the federal Medicaid program for the poor. Medi-Cal now covers 13.5 million residents – 1 of every 3 Californians – with medical, dental, mental health, sunstance use and long-term care services, according to DHCS.
Under the GOP proposal
House version
- California would receive a fixed, annual per capita cap or a "block grant" instead of a per Medicaid-enrollee structure. If the state spends more than its annual limit, it would have to repay the federal share of that amount the following fiscal year
- Federal funding for states that expanded Medicaid would cease by 2020. Americans on Medicaid would also be required to refile paperwork every six months to continue receiving benefits, which the California Department of Health Care Services says would create a barrier, causing individuals to lose coverage
Senate version
- The Senate version would implement an annual per capita spending limit similar to the House bill until the start of the 2025 fiscal year, in which it will further reduce the spending limit more than the House bill. That means the cost burden will be "more catasrophic" for California, according to DHCS analysis.
- Federal funding for expanded Medicaid would be phased out by 2021
Estimated amount of Medi-Cal costs that would exceed the GOP's proposed limit
Estimated amount of Medi-Cal costs that would exceed the GOP's proposed limit
California's elderly and disabled
Both the Senate and House bills would cut 6% of federal funding for In-Home Supportive Services (IHSS) programs would be cut by 2020, moving $400 million in costs onto California, according to DHCS. The state's IHSS program is the largest in the country, allowing the elderly and disabled to receive care in their homes instead of in a hospital or other costly institutional settings.
Planned Parenthood services in California
Both bills would impose a one-year federal funding freeze any health clinics that provide abortion services. In the Golden State, that would affect the Planned Parenthood Affiliates of California, which serves more than 600,000 Medi-Cal and Family Planning, Access, Care and Treatment program beneficiaries, who are predominantly low-income women. The one-year prohibition would equal more than $400 million in added costs to the state, according to the California Department of Health Care Services.
Sources: California Department of Health Care Services, Times reporting
Credits: Additional reporting by John Myers
UPDATES:
June 29, 11:47 a.m.: This article was updated to include the California Department of Health Care Services's assessment on the Senate bill.