California Democrats have approved a budget plan that would extend Medicaid coverage to young people regardless of immigration status and essentially reinstate the Affordable Care Act’s (ACA's) individual mandate.
The budget (PDF) includes an additional $98 million in funding for Medi-Cal, the state’s Medicaid program, to cover undocumented immigrants aged 26 and under. Should the budget be finalized, the option would be available beginning in January.
Gov. Gavin Newsom’s administration estimates that the policy would enroll an additional 90,000 in Medicaid in the first year. A plan to extend similar coverage options to undocumented seniors was removed from an earlier version of the budget.
The budget also proposed increased subsidies for eligible people enrolling in plans on Covered California, the state’s ACA exchange. To fund these payments, California would establish an in-state individual mandate to replace the nationwide one repealed in 2017.
Under the plan, California would become the first state to offer ACA plan subsidies to people making 600% of the federal poverty level. State officials estimate that people making between 400% and 600% of poverty would earn about $100 per month in subsidies to assist in paying for Covered California plans.
Newsom said in a statement that the budget is “structurally balanced and invests in a California for all.”
"The budget adopted by the Conference Committee is balanced, creates historic reserves and expands budget resiliency,” he said.
The health initiatives included in the budget proposal are significant political wins for Newsom, who pushed hard for both. The budget will still need to go before the full California legislature for approval, and legislators have until June 15 to finalize a budget.
State Sen. Holly Mitchell, chair of the Senate Budget and Fiscal Review Committee, said Sunday that the plan builds on Newsom’s goals while also adding in “significant legislative priorities.”
Overall, California officials have included $93.5 billion to fund Medi-Cal in 2018-19 and $102.2 billion in 2019-20. About $3 billion of the increase in 2019-20 is attributable to plans to end a tax on managed care organizations, according to the budget document.