SACRAMENTO (CBS / AP) — Gov. Jerry Brown told county officials Wednesday that the state cannot afford to “double-pay” as he seeks to expand California’s health care program for the poor, meaning counties will have to forfeit millions of dollars in state funding.
The Democratic governor told the California State Association of Counties that without the additional funding, the state will not be able to expand Medi-Cal as part of President Barack Obama’s health care overhaul. Brown’s budget proposal calls for counties to return about $300 million to cover 2 million to 3 million people in the next fiscal year.
“I want you to share at least $300 million with the state. So that’s the bottom line,” he said in an address to the group.
Brown said accepting the Medicaid expansion as part of Obama’s health care reforms is “a bold move” and the right thing to do. He acknowledged that counties have no way of knowing how much they will save from the shift, since they will still be responsible for millions of uninsured residents and are required to offer other health programs not covered by Medi-Cal, as Medicaid is known in the state.
“But in principle, if you have Family A and you take care of them under your indigent care and all of a sudden Medi-Cal takes care of `em, then you’ve got to shift that money to us. If you don’t shift that money, we can’t expand,” he said.
Matt Cate, executive director of the association, said the counties have given Brown a counter-proposal and are in talks with him.
“There isn’t $300 million; that’s the problem,” he said. “We’re willing to give. We just don’t want to get to a place where they scrape off so much that we’re left in a worse state than we were before.”
The federal government will pay 100 percent of the costs for newly eligible Medi-Cal recipients from 2014 to 2016, so Cate said it will become clearer over time how much money the counties save.
Brown also briefly addressed his prison realignment law, which aims to ease prison overcrowding by sending thousands of lower-level offenders to county jails instead of state prisons.
Many parole violators serve little or no time because jails have become overwhelmed. The law, which was passed in part to comply with a federal court order, has become a key talking point for Republicans as Brown faces re-election next year.
“We haven’t finished working out the realignment … because realignment is just not about fewer people in prison. It’s about dealing with mental health, dealing with drug treatment. It’s dealing with family stability. It’s dealing with a lot of stuff,” Brown said.
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