Transcription
Counties are the entities that implement the safety net, but we have very limited control over the funding of these programs. They are all funded by state and federal government. Our current circumstances do not reflect a county-created crisis, and it is not a problem which counties should be expected to solve alone.
This is not a one-year challenge. The cuts directed by HR1 have created structural, ongoing impacts that will challenge the already fragile safety net for years to come. And if counties are forced to redirect limited general fund dollars to backfill these cuts, programs on which residents rely, including public safety and prevention services, will be reduced or eliminated. We need the state's partnership to prevent that outcome.
First, stabilizing public hospital systems. In this county alone, HR1 creates a $1 billion annual deficit for our public health care system. We support the California Association of Public Hospitals' current request for a $500 million state investment to replace the non-federal share of Medicaid fee-for-service that public hospitals currently shoulder alone. This is a conservative ask because it would only bring public hospitals to parity with privates and doesn't account for the fact that though public hospitals comprise only 6% of hospitals across the state, we provide more than 50% of trauma care. We'll also seek rate adjustments for public hospitals for trauma and burn services and additional asks in subsequent years.
Second, investing in the workforce required to implement federal changes. Biannual redeterminations will double eligibility workloads at a time when counties are already struggling to hire and retain staff. Here, we support the County Welfare Director's Association's request for $373 million in the upcoming fiscal year to ensure medical and CalFresh administration are adequately funded.
That the state should be considering is the modernization of the data systems that are used by all county eligibility workers, so they have the capacity to actually automate incredibly time-consuming work to collect employer verification and other burdensome documents that are now required with the precise intention of making it more difficult to secure successful redetermination.
Third, providing counties with a minimum of $2 billion annually to address the expected surge in uninsured residents. Millions of Californians who are currently eligible for Medicaid are projected to lose coverage due to new federal requirements and the expiration of Covered California subsidies. The California State Association of Counties estimates county costs between two and five and a half billion dollars each year. Counties are doing everything within our control to manage significant levels of unreimbursed care. Without meaningful state partnership, the safety net will erode and crumble.