Obamacare is unsustainable in California

CalWatch: A large health care hole has developed in the current state budget, driven by the increased Medi-Cal enrollment under the rules set by the Affordable Care Act. But no consensus has formed around how to fix it. “The administration, lawmakers and health plans continue to be deadlocked on Brown’s proposal to expand a tax on health plans to help generate about $1 billion for Medi-Cal,” the Sacramento Bee noted. “Republican critics say the new tax would saddle millions of health plan customers with higher costs. But administration officials have warned that the lack of a replacement tax would force offsetting health care cuts in the governor’s budget,” while some Democrats have joined Republicans in questioning the wisdom of a refashioned tax, the Bee added.

The current tax supplying Medi-Cal with funding will expire in June. “The governor’s chief adviser, Nancy McFadden, has cautioned against relying on the extra tax money coming in,” the Associated press reported. “Even as more people enroll, the program faces a shortage of doctors since reimbursement payments were slashed by 10 percent during the recession.”

Meanwhile, on infrastructure, the governor’s office has also faced an uphill climb. “Brown proposed a mix of taxes, fees and cap-and-trade money that he said would generate about $3.6 billion annually,” as the Bee noted. “But Republicans have vowed to reject any plan that includes a tax increase, and negotiations remain on idle.” Because tax increases require a two-thirds vote of support in the Legislature, Republicans have been able to flex their muscle. But some hopes have centered around a proposal by State Sen. Jim Beall, D-San Jose. His plan “would raise an additional $4.5 billion a year for highway maintenance projects and $1.5 billion for mass transit improvements, such as BART extension lines to Livermore and Richmond,” without allocating any spending to the state’s high-speed rail endeavor, according to the San Jose Mercury News.

And when the recession hits, the Medical enrollment jumps while employee covered health care drops, thus making the  budget even more constrained. Managing the dynamics is  way beyond the California political machine.