A vital boost for Medi-Cal
California has come up with a sound system for assuring access to hospitals for the one in three residents who rely on Medi-Cal. For the past seven years, hospitals have paid fees totaling up to $5 billion a year so the state can meet the matching requirement for federal support for the health care program for children, seniors, lowincome families and people with disabilities.
Those federal dollars amount to about $4 billion a year.
Proposition 52 would make that fee permanent. It also would deter the Legislature from tapping those funds for other programs — a very real threat, as demonstrated during the depths of the recession, when nearly $500 million was diverted to the state’s general fund.
As proponents of Prop. 52 are quick to remind, an economic downturn is when those health care dollars are needed most, when workers lose jobs that provide insurance coverage.
We generally object to voter-mandated set-asides. But this one merits an exception for two important reasons. One is that this is a fee imposed on hospitals for a specific purpose. Also, every dollar that is diverted to the general fund results in the loss of a dollar in federal matching funds for hospital care.
It’s also worth noting that California hospitals and their industry associations are advocating passage of Prop. 52. They know that this stable source of federal support is vital to preventing closures or cutbacks in services.
Even Californians who are not served by Medi-Cal have a stake in Prop. 52: Their own premiums could rise if hospitals were to shift costs onto other patients to offset the loss of government support.
This fee was established by the Legislature by an overwhelming vote in 2009 and renewed in 2013. It is scheduled to sunset at the end of 2017.
While it seems unlikely that lawmakers would allow this critical program to expire, voters should seize the opportunity to not only guarantee that it will continue, but to require a twothirds vote of the Legislature to divert any money from it.
We recommend passage of Prop. 52.