California Gov. Gavin Newsom wants the state to provide health coverage to low-income young adults who are in the country illegally, but his plan would siphon public health dollars from several counties battling surging rates of sexually transmitted diseases and, in some cases, measles outbreaks.
Public health officials describe the proposed reallocation of state dollars as a well-meaning initiative that nonetheless would have "dire consequences" to core public health services.
There have been 764 confirmed cases of measles this year through May 3 in 23 states, including California, the highest number since 1994, the Centers for Disease Control and Prevention reported Monday. State public health officials also are struggling to address record rates of sexually transmitted diseases, with more than 300,000 cases of gonorrhea, chlamydia and syphilis reported in 2017.
The reallocation of state money "would exacerbate our already limited capacity to respond to outbreaks and public health emergencies," said Jeff Brown, director of Placer County's Health and Human Services Department, which has responded to three measles cases so far this year.
California already allows eligible immigrant children up to age 19 to participate in Medi-Cal, the state's Medicaid program for low-income residents, regardless of their immigration status. The current budget sets aside $365.2 million to pay for the coverage.
In his 2019-20 budget plan, Newsom proposes expanding eligibility to unauthorized young adult immigrants from age 19 through 25.
His office estimates it would cost nearly $260 million to cover them in 2019-20. While state and federal governments usually share Medicaid costs, California would have to bear the full cost of covering this population.
To help pay for it, Newsom proposes to redirect about $63 million in state funds from 39 counties, arguing they would no longer need to provide health benefits to low-income young adults covered by the state.
"As the state takes on responsibility for providing health care to undocumented adults, counties' costs and responsibilities on indigent health care are expected to decrease," Jenny Nguyen, a budget analyst at the state Department of Finance, told lawmakers at a recent legislative hearing.
Under the governor's 2019-20 budget plan, which requires legislative approval, 35 mostly small and rural counties expect to lose about $45 million in state money that funds health services for uninsured residents, including undocumented immigrants. Those counties -- which participate in something called the County Medical Services Program -- aren't expected to feel an immediate financial impact because the program has a budget surplus.