Marvin Estela Pineda, right, from El Salvador, who is blind from glaucoma, receives eye drops from his daughter, Made, at their home in Madera, Calif., Thursday, May 30, 2024. California Gov. Gavin Newsom has faced criticism for his proposal to eliminate optional Medicaid benefits for some immigrants with disabilities. (AP Photo/Gary Kazanjian)
SACRAMENTO, Calif. (AP) — California Gov. Gavin Newsom has vowed not to close the state's budget deficit by taking away health insurance from low-income adults living in the country without legal authorization, calling the state's policies “ones I believe in.”
But Newsom plans to eliminate key health benefits for some low-income immigrants with disabilities, leading his allies to accuse the now two-term governor of breaking his promise.
California was one of the first states to offer free health insurance to all low-income adults, regardless of immigration status. The multi-billion-dollar project, completed in January, made more than a million people eligible for California's Medicaid program, including many who never had health insurance before.
Now, just five months later, with California facing an estimated $45 billion deficit, Newsom wants the state to stop paying for some disabled people — those living in the country without legal permission — to bring caregivers into their homes to cook, clean and do other chores so they don't have to go into nursing homes, while others can continue to get those benefits.
The Newsom administration has said it will save about $94 million and affect fewer than 3,000 of the more than 15 million people enrolled in the state's Medicaid program, known as Medicaid, but eliminating the benefit means thousands more will lose eligibility in the future.
Newm's proposal is “a betrayal,” said David Cain, an attorney at the Western Law and Poverty Center. Ronald Coleman Baeza, managing director of policy for the California Pan Ethnic Health Network, called the proposal “indefensible” and compared it to an infamous 1990s ballot proposition that sought to bar immigrants from accessing government assistance programs.
“I think we could be going backwards in terms of giving special treatment to undocumented immigrants,” said Sen. Maria Elena Durazo, a Democrat from Los Angeles who has pushed for Medicaid expansion for years.
Newsom's immigration proposals would affect benefits known as in-home supportive services that are becoming increasingly expensive for states to provide — the average hourly rate for caregivers has risen 6% since 2014 — and some emergency federal funding provided during the pandemic expired this year, raising costs by about $200 million.
Once a person qualifies for the program, they can hire their own caregiver, who is often a relative, so the program often functions as a financial aid to the family.
Marvin Estela Pineda, a 42-year-old woman from El Salvador who now lives in California's Central Valley, lost her sight to glaucoma when she was 30. She began receiving in-home support services earlier this year.
Her daughter, Maide Pineda, said the government pays her $16.50 an hour for 84 hours a month to care for her mother, including cooking, cleaning and laundry. Maide Pineda, 22, said the money helped provide financial stability for her family until she could finish college.
“Without (the program), I wouldn't be able to take care of her without a lot of trouble,” Maide Pineda said.
The California Department of Social Services, which administers the program, said it would work to “mitigate any adverse impacts to individuals currently receiving assistance,” including by helping them find other government-funded programs that could provide similar services. One option is Medi-Cal's Community-Based Adult Services program, which covers costs such as personal care, meals and skilled nursing services.
When asked for comment on Newsom's proposal, the governor's office pointed to comments Newsom made earlier this month when he unveiled a budget proposal that included a series of painful cuts.
“We take no pleasure in this, but we have to do it and we have to be responsible. We have to be accountable. We have to balance the budget,” Newsom said.
Mr. Newsom won praise from progressives for much of his time in office as he used one historic surplus after another to expand government services, but a string of multi-billion-dollar deficits has forced him to make tough choices and put him at odds with some of his most vocal supporters.
Navigating those conflicts is crucial for Mr. Newsom, who has been gaining national publicity ahead of the presidential election. So far, he has moved quickly to address them. After the state's largest teachers union ran an ad criticizing proposed cuts to the education budget, Mr. Newsom reached a deal with the union that addressed many of the union's concerns. The deal must be approved by the state Legislature.
Other negotiations will be more difficult. Governor Newsom's immigrant health insurance proposal is just one of many proposed cuts across the state's broad range of social service programs.
The Democratic-controlled state Legislature is expected to pass its own budget by June 15 that would restore nearly all of the cuts, including health care cuts for some immigrants. Their plan would do so by increasing temporary tax increases on businesses and cutting the state prison budget by about $1 billion.
“We made sure that the budget was not biased towards the most vulnerable,” said Rep. Corey Jackson, a Democrat from Moreno Valley.
Newsom and legislative leaders will discuss a final spending plan over the next few weeks, with the goal of passing the budget around the start of the new fiscal year on July 1. While the Legislature votes on the budget, Newsom has significant influence. He decides whether to sign the budget into law. The California Legislature has rarely overridden a gubernatorial veto.
Adam Beam, The Associated Press
