Wednesday, November 27, 2013

The Health-Care Spoiler in California’s Rosy Budget

Despite a 30 percent increase in the top income tax rate, higher sales taxes and fees, and greater total revenue, the state is spending less on education, transportation, courts, welfare and parks than it was six years ago. The reason: State spending on health care, employee compensation and benefits, interest, and prisons is greater than it was six years ago. - Bloomberg

The largest spending growth is in Medi-Cal, which is California’s version of Medicaid. The program is the state’s second-largest and fastest-rising expenditure, and accounts for most of the Department of Health Care Services’ outlays, which grew 65 percent over the six-year period, to $24 billion a year, from $14 billion. (See chart.)


Worse, the increase in Medi-Cal costs occurred before implementation of the Patient Protection and Affordable Care Act. The law is expected to cost the state budget an additional $2 billion to $4 billion in health-care spending a year, according to the Rand Corp. That means even less money for California’s colleges and universities, parks, courts, transportation, environment, and welfare, and even more pressure for fee and tax increases.

...Politicians love to make promises, but they don’t like to tell citizens about the costs of those promises or to challenge powerful lobbies funded in part by expenditures approved by those politicians. To protect its public services and residents, California’s leaders will sooner rather than later have to face down the elephant in the budget, Medi-Cal.