The California Legislature passed the $96.3 billion budget bill (AB 110) by its June 15th constitutional deadline, which was signed by Governor Jerry Brown late last week. “California’s finances are in very solid shape for the first time in a decade,” said Governor Brown, “We’re making significant investments in the things Californians care most about – the education of our children and adequate health care.” The Governor also signed a handful of “budget trailer bills” that provide the policy framework to implement many new provisions in the enacted budget.
Key Signed Budget trailer bills include:
- AB 74 (Human services): Implements the IHSS Statewide Public Authority,
- AB 82 (Health): Among other things, AB 82 would authorize the Controller to use the funds in the Long-Term Quality Assurance Fund for cash flow loans to the General Fund, as specified,
- ABX1 1 (Medi-Cal: eligibility): Expands Medi-Cal coverage for those under 65 and have incomes up to 133 percent of the federal poverty level to comply with the Affordable Care Act,
- SB 78 (Public health: Medi-Cal managed care plan taxes): Reauthorizes a gross premium tax on Medi-Cal managed care plans from July 1, 2012 until July 1, 2013. Specifies that $125 million of the revenues from this tax be used to fund the Healthy Families Program and the remaining revenues be directed to the Department of Health Care Services for purposes of funding managed care rates for health care services for children, seniors, persons with disabilities, and dual eligibles in the Medi-Cal program. Establishes a sales tax on Medi-Cal managed care plans beginning July 1, 2013 (through 2016) to support managed care rates for the same population.
- SB 94 (Medi-Cal: managed care: long-term services and supports: in-home supportive services): SB 94 implements several provisions of the Coordinated Care Initiative (CCI). The CCI provides persons eligible for both Medicare and Medi‑Cal (dual eligibles) will receive medical, behavioral health, long‑term services and supports, and home and community‑based services through a single health plan. The CCI will also enroll all dual eligibles in managed care plans for their Medi‑Cal benefits. Dual eligibles will enroll in the CCI in specified counties participating in the demonstration. The Budget includes the following significant changes:
- Addresses the “de-linking” of the program components. (See related article)
- The size and scope of the demonstration has been revised as agreed to in a Memorandum of Understanding with the federal government. The Budget reflects the population participating in the demonstration and accounts for a cap on the number of beneficiaries from Los Angeles County.
- The Budget changes the scheduled phasing for beneficiaries enrolling in the CCI. Beneficiaries in the eight participating counties will enroll in the demonstration no sooner than January 2014. Los Angeles County will phase‑in beneficiaries over 12 months, subject to further discussions with the federal government. San Mateo County will enroll all beneficiaries in January 2014. Orange, San Diego, San Bernardino, Riverside, Alameda, and Santa Clara counties will phase‑in beneficiaries over 12 months.
- The Budget projects revised General Fund savings for CCI of $119.6 million in 2013‑14. This amount includes the net benefit of moving to a higher tax rate on Medi‑Cal managed care plans. The Budget also enacts statutory changes to reflect the changes in the implementation schedule and to authorize the integration of Medi‑Cal long‑term services and supports as a managed care benefit even in the event Medicare benefits are not incorporated.
- The Budget includes $518,000 ($259,000 General Fund) and 4 positions in the Department of Social Services to staff the Statewide Authority, which is responsible for collective bargaining with unions representing individual providers in counties that have transitioned to the CCI. The Administration expects to convene the Statewide Authority before the first county completes its transition into managed care.
