On June 30, 2022, the California Governor, Gavin Newsom, signed the 2022-2023 budget into law. The state’s historic $308 billion state budget will expand health care coverage for millions of low-income Californians, improve health care access for all Californians, protect reproductive freedoms and expand reproductive health care, and provide additional mental health resources for youth and adults. The budget will transform California’s health care systems by expanding access to Covered California and Medi-Cal, making health coverage more equitable and affordable for Californians.
“We commend the Governor and Legislature for their commitment to supporting the health care needs of low-income and underserved people in this state,” said National Health Law Program Managing Attorney, Kim Lewis. “Strengthening the publicly funded health care programs and making sure they are affordable will help ensure all individuals and families who rely on these programs can access health care they need to thrive.”
Here are some of the key health care benefits in the budget:
- Remove immigration status as a barrier to Medi-Cal for 700,000 income-eligible Californians ages 26-49: by January 2024, California will become the first and only state in the nation to expand Medicaid coverage to all income-eligible Californians regardless of immigration status.
- Eliminate premiums in Medi-Cal: the budget will reduce Medi-Cal premiums to zero for over 535,000 children, pregnant individuals, and people with disabilities. This makes it easier for low-income individuals and families to access the care they need.
- Reduce the Medi-Cal share-of-cost: beginning July 1, 2025, Medi-Cal share of cost will be reformed for low-income seniors and people with disabilities by increasing the maintenance need income level to 138% of the federal poverty level, subject to a budget appropriation.
- Ensure continuous coverage in Medi-Cal for children 0-5 years old, subject to a federal approval and budget appropriations.
- Include Community Health Workers in Medi-Cal: funding to recruit, train, and certify 25,000 new community health workers by 2025 in areas such as climate health, homelessness, and dementia.
- Invest over $200 million to expand access to abortion, sexual, and reproductive health care to provide for: uncompensated care; equity and infrastructure payments for clinic abortion providers; reproductive health care services scholarships/loan repayments; reproductive health center physical and digital Infrastructure and security; recruitment and retention resources to ensure clinicians and other health workers have access to abortion training; the California abortion support fund; Los Angeles County reproductive health pilot program; premium subsidy payments; the reproductive justice and freedom fund; backfilling lost Title X Family Planning Funds; family planning, access, care; and a reproductive rights website and research on unmet reproductive health care needs.
- Increase funding for doulas serving Medi-Cal beneficiaries: funding to make targeted payments to Medi-Cal managed care plans or providers to improve quality measures in maternity care by providing doula benefits under Medi-Cal and increasing the reimbursement rate from $450/birth to $1094/birth.
- Increase funding in the Children’s Behavioral Health System: over the next three years the budget will further invest in the Children’s Behavioral Health System to address urgent needs, including the establishment of a peer-to-peer mental health support program in high schools.
- Continue telehealth coverage and payment by DHCS: the budget will ensure continued coverage and payment parity of synchronous telehealth, both video and audio-only, and asynchronous telehealth modalities for all providers.
- Invest in Medi-Cal community-based mobile crisis intervention services: the budget will explicitly implement Qualifying Community-Based Mobile Crisis Intervention Services as a Medi-Cal state plan benefit through the Medi-Cal behavioral health delivery system.
- Establish an Office of Health Care Affordability: this new office will work to set enforceable cost targets for the health industry and contain the rising cost of care.
- Restart state subsidies in Covered California: in the case that federal enhanced subsidy funding ends, the state subsidy program will be reinstated to provide premium support for Californians under 600% of the federal poverty level.
Overall, this year’s budget will benefit and improve the lives of millions of Californians, especially communities who have been underserved. Although this year’s historic budget has strengthened publicly funded health care programs, there is much more work that needs to be done to make sustainable, long-term investments that will advance health equity and improve the health of all Californians. California leadership must continue to invest in affordable health care services, and the community-based organizations who provide these services, to ensure that people in this state that face the greatest inequities get their health care needs addressed.