On June 29, 2024, Governor Newsom signed and delivered California’s 2024 fiscal budget. In a press release by the Governor and legislative leaders, the state announced its plan to balance the budget while addressing a $46.8 billion deficit inherited from previous years. The state’s aim was to bring “stability to state finances while preserving key investments in safety net programs.”
NHeLP acknowledges the challenges faced by the Administration in addressing previous shortages and we commend the Governor and Legislature for their efforts to maintain health care access for low-income and underserved people in the State. While several key health care measures were maintained in the final budget, others that are vital to the health of low-income Californians were excluded. These shortcomings could undermine access to quality health care for the underserved. Positive outcomes included:
- Maintaining targeted Medi-Cal rate increases for transportation services, community health workers (CHWs), community-based adult services, and pediatric day care;
- Keeping other targeted Medi-Cal rate increases such as family planning and abortion services, effective January 1, 2025;
- Funding to implement multi-year continuous Medi-Cal coverage for young children aged 0–5, to begin 2026 (if the MCO Provider Tax Ballot Initiative fails);
- Maintaining Medi-Cal coverage of acupuncture services, which represent an alternative to opioid-based treatment for pain and are important for the State’s continuous fight against the overdose epidemic;
- Rejecting cuts to vital health care and social services programs and maintaining funding for programs such as the Indian Health Program, and Family Urgent Response System (FURS) for current and former foster youth;
- Rejecting proposed cuts to In-Home Supportive Services (IHSS) for undocumented Medi-Cal recipients;
- Preserving $8 million for Health Enrollment Navigators at Clinics.
Cuts to critical health care programs included:
- Elimination of Health Enrollment Community-Based Navigators who provide vital and trusted assistance with accessing and maintaining health coverage. Navigators provide critical, culturally informed assistance to underserved Medi-Cal applicants and beneficiaries. This loss cuts deep as county Medi-Cal offices continue processing over a million backlogged unwinding-related renewals. Hundreds of thousands of immigrants also just secured Medi-Cal coverage this year through Medi-Cal expansion, and these coverage gains are jeopardized due to the navigator cuts;
- Exclusion of Medi-Cal share of cost reform that was part of the 2022–23 state budget was supposed to begin January 1, 2025. This means that older adults and people with disabilities will continue to be unable to access medical care due to incomes just above already low-income thresholds;
- No additional funding to develop a marketplace exchange for undocumented immigrants so that they can access Covered California coverage.
These budget cuts will have a disproportionate effect on low-income and underserved communities, including BIPOC, immigrants, and people with disabilities. For example, the navigator program was designed to address gaps in providing care to communities that face the greatest inequities in getting their health care needs addressed by providing culturally informed assistance.
While the Governor was charged with a difficult deficit budget year and we appreciate the administration’s efforts to preserve quality health care considering the state’s economic reality, we believe more work needs to be done to advance health equity and improve the health of all Californians.
