Exclusive: Newsom faces fallout with key health care allies over Medi-Cal
Over 120 major organizations throughout California, including health providers, unions and religious groups, are issuing a warning to Gov. Gavin Newsom: Keep Medi-Cal funded, or you'll lose our support.
Why it matters: Newsom ran on a universal health care platform. But with a $68 billion budget deficit and presidential ambitions on the horizon, access for the state's most vulnerable populations could now be on the chopping block.
Zoom in: Under Newsom's proposal, undocumented immigrants 19 and older would be entitled to emergency medical and pregnancy care but lose coverage for expenses like prescription drugs, dental care and doctor's visits if they don't enroll before January.
Starting in 2027, the state would also add a $100 per month premium for adults whose immigration status makes them ineligible for federal Medicaid, including those with legal status.
Community-facing clinics would see their reimbursement rates cut as part of the plan.
Driving the news: A new open letter, spearheaded by Health Justice Action Fund and St. John's Community Health, blasts Newsom for attempting to "balance the budget on the backs of poor and working Californians" and creating a system that discriminates against immigrants.
"People will die. That is not political rhetoric, but a grim reality when chronic conditions go unmanaged, emergencies go untreated, and facilities are forced to shutter," the letter states.
"[O]ur goal is to make sure everyone gets the care they need, but these cuts will make that impossible," Bay Area health care worker Ron Cook told Axios via email.
Threat level: Newsom's proposal would force California health clinics to face a 20% cut in funding on top of the 10% reduction to Medicaid currently making its way through Congress, the letter notes.
It'd jeopardize 2,300 health service sites and lead to loss of access to primary care, mental health services and life-saving medications for 1.6 million Californians, per the letter.
Signees include the Bay Area-based North East Medical Services, La Clínica de La Raza, Inc. and Gardner Health Services.
What they're saying: The budget proposal "was kind of a five-alarm fire," St. John's president and CEO Jim Mangia told Axios.
After California expanded coverage for undocumented immigrants last year, many are finally seeing a doctor, getting their diabetes under control and having their hypertension treated, Mangia said. "The thought of losing it is devastating."
The other side: Newsom's office did not immediately return a request for comment, though he has said Medi-Cal expansion cost the state more than expected — about $8.5 billion from the general fund annually.
Between the lines: Many community health groups supported Newsom in his run for governor, but his White House ambitions have created a rift, with some advocates accusing him of catering to Republicans by targeting immigrants and trying to avoid raising taxes.
"Everything at this point, unfortunately, is about the political calculation of a presidential campaign, not about what's needed by the people of California," Mangia said.
What we're watching: Mangia acknowledged the reality of the budget deficit but emphasized that the solution lies with revenue, such as increasing corporate taxes.
Hashtags
Try Our AI Features
Explore what Daily8 AI can do for you:
Comments
No comments yet...
Related Articles
Business Wire
9 hours ago
- Business Wire
CCS Presents Four Peer-Reviewed Posters at American Diabetes Association's 85th Scientific Sessions
CHICAGO--(BUSINESS WIRE)-- CCS, a leading provider of clinical solutions and home-delivered medical supplies for those living with chronic conditions, will present four peer-reviewed posters at the American Diabetes Association's (ADA) 85th Scientific Sessions, which will take place June 20–23 in Chicago. These latest poster presentations illustrate CCS's focus on delivering evidence-based approaches to diabetes care management that ensure patients have the education and coaching they need to thrive and cost-effectively stay adherent while managing their chronic condition. "At CCS, we meet patients where they are — with empathy, education, and evidence-based support..." Share The ADA Scientific Sessions is a globally recognized conference dedicated to advancing the field of diabetes. This annual meeting serves as a critical forum for presenting cutting-edge research, innovation, and new evidence-based approaches to diabetes prevention, management, and care. Presentation Highlights from CCS at the ADA Scientific Sessions CCS's clinical strategy and innovation vice president, Coni Dennis, DNP, RN, and NE-BC, will present findings for all four accepted poster presentations at the ADA's 85th Scientific Sessions, and she shared this insight leading into the event: 'At CCS, we meet patients where they are — with empathy, education, and evidence-based support. These poster presentations reflect our commitment to improving health outcomes for people with diabetes by combining data-driven clinical insight with hands-on, compassionate care.' All poster presentations will take place at the conference on Sunday, June 22, from 12:30–1:30 p.m. CT in West Hall F1. The following are the four specific posters that CCS will be presenting: Presentation Title: Evaluating the Impact of Multichannel Diabetes Care Coaching and Education in Patients New to Continuous Glucose Monitoring Abstract Number: 534 Summary: This study, part of an ongoing randomized control trial (RCT), evaluated whether adults with diabetes newly starting a continuous glucose monitor (CGM) achieve better outcomes when they receive diabetes self-management education and support (DSMES) from a certified diabetes care and education specialist (CDCES), compared to using a CGM alone. Presentation Title: Examining the Impact of Continuous Glucose Monitoring Sourcing in Medicaid Patients — Adherence, Healthcare Costs, and Utilization Abstract Number: 1046 Summary: This study compared healthcare costs and utilization among Medicaid beneficiaries who received CGM supplies through a pharmacy or a durable medical equipment provider. Presentation Title: Healthcare Costs and Utilization Among Patients Eligible for Continuous Glucose Monitors — A Comparison of Users and Nonusers Abstract Number: 1049 Summary: This retrospective cohort study used claims data to compare glycemic control, healthcare utilization, and total cost of care over 12 months among individuals on bolus insulin who used CGMs versus those who did not. It also assessed the incidence of hypoglycemia and diabetic ketoacidosis (DKA). Presentation Title: Evaluating an Evidence-Based Quality Improvement Initiative for Food Insecurity Screening and Referral in Adults with Diabetes Initiating Continuous Glucose Monitor Therapy Abstract Number: 1143 Summary: This study assessed food insecurity (FI) among adults with diabetes initiating CGM therapy, comparing rates to national averages and examining glycemic outcomes between food-insecure and food-secure individuals. These posters will be made available on the American Diabetes Association's website after August 25. About CCS CCS is the strategic partner addressing America's most pressing healthcare challenges through intelligent chronic care management, tackling the $412 billion annual diabetes burden and chronic conditions affecting over 133 million Americans. At the core of CCS's differentiated model is LivingConnected®, a human-led, digitally enabled clinical solution. PropheSee™ — an AI-powered predictive model that identifies nonadherence risk and delivers personalized interventions — is an integral part of this solution, creating a first-of-its-kind platform to improve adherence, enhance clinical outcomes, and help prevent costly hospitalizations. By combining data-driven insights with three decades of industry relationships, CCS is the smart choice for health plans, providers, employers, and manufacturers who believe that value-based care starts by keeping patients healthy and delivers benefits like lower cost of care, improved HEDIS scores, and alleviating provider burnout. CCS's approach extends clinical reach while supporting over 200,000 people nationwide with home-delivered medical supplies and pharmaceuticals annually. Recognized as a Great Place to Work® and with numerous peer-reviewed publications validating our care management approach, CCS is more than a trusted supplier — we're a partner in transforming chronic care delivery. To learn more about how CCS is addressing today's healthcare challenges, visit or connect with us on LinkedIn.
Politico
11 hours ago
- Politico
Senate megabill will strengthen Obamacare, says red state hospital CEO
A provision in a key Senate committee's version of the GOP megabill will backfire against Republicans by forcing red states to consider doing exactly what Republicans don't want them to: expand Medicaid, the CEO of the South Carolina Hospital Association told POLITICO. Republicans have sought to shelter the 10 conservative states that have declined to expand Medicaid to cover more low-income people, as Obamacare encourages with generous federal subsidies. But the Senate bill, in an effort to find the savings needed to extend President Donald Trump's 2017 tax cuts, would still blow a hole in the budgets of Palmetto state hospitals by reducing what insurers who contract with the state to provide Medicaid services can pay them. States and Washington share the insurance program's costs. 'It affects the viability of the whole system,' said Thornton Kirby, chief executive of the South Carolina Hospital Association, which estimates the Senate proposal will cost the state over $2.3 billion annually. 'If you take away this alternative way to balance the budget, you leave us with only one path…Medicaid expansion,' Kirby said. The Senate is rushing to complete its version of a bill that would enact Trump's agenda using a procedure that requires only a simple majority vote. Trump wants it done by July 4, but with the slim margins in both houses of Congress, the industries affected by the bill are hoping to peel off votes to save themselves from cuts. Republicans can lose no more than three votes in either chamber as long as Democrats remain united in opposition. To make the case that the restrictions on so-called state-directed payments need to go, the hospital association is leaning on three home state Republicans with clout: Sen. Tim Scott, who has a seat on the Finance Committee that has proposed the restrictions; Rep. Russell Fry, who's on the Energy and Commerce Committee that drafted the Medicaid provisions of the megabill the House passed last month; and Henry McMaster, the governor of South Carolina and, Kirby said, a personal friend. 'I don't want to put him in the hot seat,' Kirby said of McMaster. 'He doesn't want to see [Medicaid] upended.' Of Scott, Kirby said he's in touch at least every other day and that the senator and Trump ally 'has been a champion.' 'He understands…he doesn't want to go down that path' of Medicaid expansion, Kirby added. The three Republicans did not immediately respond to requests for comment. Expanding Medicaid could help replace the revenue the Senate provision would take away because it would make many more people — South Carolina now has one of the nation's higher uninsured rates at 9 percent — eligible for the program. Under Obamacare, the federal government picks up 90 percent of the cost for the new enrollees. Under the Finance Committee proposal, state-directed payments to hospitals serving Medicaid patients would fall by 10 percent each year until the total payment rate is only 100-110 percent of the Medicare payment rate. In South Carolina, the current payment rate is more than twice the rate paid by Medicare, the federal health insurance program for elderly people. Hospitals in states that have expanded Medicaid would take an additional hit under the Senate proposal. The Finance Committee would lower the provider tax rate that the 40 states that have expanded Medicaid can levy on hospitals from 6 percent to 3.5 percent. States have used the taxes to boost their federal matching funds, which they have then sent back to hospitals in higher reimbursements. The Senate would freeze the tax rates in states like South Carolina that haven't expanded Medicaid, but would not require them to lower them. The version of the megabill the House passed would freeze the rates for all states, a plan Kirby was willing to accept. On Friday, Sen. Josh Hawley (R-Mo.) urged GOP leaders to strike the Finance Committee language on Medicaid, warning the crackdown won't clear the House. Republican senators hope to pass their version of the bill next week after which the House would need to pass it before Trump could sign it into law.
The Hill
11 hours ago
- The Hill
Trump administration makes sweeping changes to ObamaCare, ends ‘Dreamer' coverage
The Trump administration is shortening ObamaCare's annual open enrollment period and ending the law's coverage of immigrants that entered the U.S. illegally as children, according to a final rule announced Friday. The Biden administration made it easier and more affordable to sign up for Affordable Care Act plans, causing enrollment to swell to an all-time high. The Trump administration claims those moves opened a wave of fraudulent enrollment that's costing taxpayers billions of dollars. According to the rule, the federal open enrollment period will run from Nov. 1 through Dec. 31. Currently, federal open enrollment ends Jan. 15. States operating their own health insurance exchanges will have the flexibility to set their own open enrollments, so long as they run no longer than nine weeks between the November and December dates. In addition to the shortened enrollment period, the administration said it is ending ObamaCare coverage for immigrants that came into the U.S. illegally as children, also known as 'Dreamers.' The provision will undo a Biden-era rule that was estimated to allow 147,000 immigrants to enroll in coverage. A federal judge blocked the rule from being enforced in 19 states, and it is still being litigated. The administration also banned plans from covering 'sex-trait modification' as an essential health benefit beginning in plan year 2026. The policy will apply to the five states that currently include coverage for gender-affirming care, as well as in states that do not have such coverage expressly mentioned. But many of the other changes announced Friday will only last a year, like requiring more income verifications for people to enroll in coverage on federal exchange plans. The one-year sunset is a change from when the rule was proposed in March. It's designed to give Republicans on Capitol Hill an opportunity to codify the provisions into law for the long-term and use the savings to fund their massive party-line tax and spending bill. According to the Centers for Medicare and Medicaid Services (CMS), the rule is projected to save up to $12 billion in 2026 by 'reining in wasteful federal spending, and refocusing on making health insurance markets more affordable and sustainable for hardworking American families.' For instance, the rule requires federal exchange plans to check consumers' eligibility for special enrollment periods and raise the burden of verification for people who are automatically re-enrolled in subsidized plans. The rule also requires plans to charge those people a $5 monthly premium until they confirm or update their eligibility information. The rule also ends a monthly special enrollment period for people with income below 150 percent of the federal poverty line, which CMS said 'has been exploited to enroll consumers or change their plans without their knowledge.'
