California has a $6.2 billion Medicaid funding gap partly due to expanding immigrant coverage
SACRAMENTO, Calif. (AP) — California faces a $6.2 billion budget gap in the state's Medicaid services, which could force Democratic Gov. Gavin Newsom and Democratic lawmakers to reevaluate future coverage for some of the 15 million people who receive health care through the program, including immigrants.
The shortfall comes a year after California launched an ambitious coverage expansion to provide free health care to all low-income adults regardless of their immigration status. That's costing far more than the state projected.
California also is bracing for major budget hits if Republicans in Congress follow through with a plan to slash billions of dollars in Medicaid and potentially jeopardize coverage for millions of people. California provides free health care to more than a third of its 39 million people.
Here's what to know about California's Medicaid gap:
Did expanding coverage to adult immigrants cause the gap?
Partly. California first extended health care benefits to low-income children without legal status in 2015 and later added the benefits for young adults and people over the age of 50. The program was expanded again last year to cover adults ages 26 to 49.
The cost of the recent expansion to cover all low-income adults is $2.7 billion more than the state budgeted because California underestimated the number of people who would sign up for services. California officials said they only had a month of data last year when the state had to produce projections for the budget.
The state hasn't said how many people have enrolled through the expansion. Last year, the state projected about 700,000 state residents who are living in the U.S. illegally would gain full health coverage to access preventive care and other treatment.
Other factors that are putting pressures on state budgets across the country also played a role in California, state officials said. Those included $540 million in rising pharmacy costs and $1.1 billion from other issues, such as a larger enrollment by older people.
In Illinois, which also expanded coverage in recent years to more low-income residents regardless of immigration status, Democratic Gov. JB Pritzker is proposing a $330 million cut to coverage for immigrants ages 42 to 64, citing rising costs.
What is California doing about the shortfall?
Newsom's administration last week told lawmakers it took out a $3.44 billion loan, the maximum allowed under state law, from the general fund to make payments for this month.
The Department of Health Care Services, which oversees the state's Medicaid program, this week said it will need an additional $2.8 billion to cover costs already committed through June. That money will need to be approved by the Legislature in April.
The state has proposed ending pandemic-era protections that have prevented it from disenrolling people from Medicaid. Newsom's administration is also bracing for 'significant variability' after President Donald Trump's immigration crackdown.
Will California roll back coverage for immigrants without legal status?
Newsom told reporters this week that rolling back the coverage expansion 'is not on my docket.'
Other Democratic leaders, including Speaker Robert Rivas and Senate President Pro Tempore Mike McGuire, also vowed to safeguard benefits for immigrants but acknowledged 'tough choices ahead.'
The budget hole has reignited criticism from Republican lawmakers about the expansion.
'Californians should not be forced to shoulder the burden of radical Democrats' reckless financial mismanagement,' state Sen. Brian Jones said in a social media post this week.
Newsom recently defended the expansion in one of his podcast episodes, adding that making preventive care accessible to all low-income people helps save the state money in the long run.
How will Congress' plan to cut Medicaid funding affect California?
The $6.2 billion budget gap is 'solvable," lawmakers said this week. But Congress' threats of a Medicaid funding cut could add further strain.
California would have to cut coverage, limit enrollment or raise taxes to help cover the costs if Congress follows through.
State officials said they're certain it would upend coverage for millions of people in the state.
Even with the largest state budget in the country at roughly $322 billion, California doesn't have the capacity to backfill services funded by the federal government, officials said.
More than half the state's Medicaid funding comes from the federal government. For the next fiscal year, that's roughly $112.1 billion. Federal funding doesn't cover costs related to preventive care for immigrants without legal status.
Hashtags
Try Our AI Features
Explore what Daily8 AI can do for you:
Comments
No comments yet...
Related Articles
Yahoo
16 minutes ago
- Yahoo
‘We've lost the culture war on climate'
President Donald Trump's latest climate rollback makes it all but official: The United States is giving up on trying to stop the planet's warming. In some ways, the effort has barely started. More than 15 years after federal regulators officially recognized that greenhouse gas pollution threatens 'current and future generations,' their most ambitious efforts to defuse that threat have been blocked in the courts and by Trump's rule-slicing buzzsaw. Wednesday's action by the Environmental Protection Agency would extend that streak by wiping out a Biden-era regulation on power plants — leaving the nation's second-largest source of climate pollution unshackled until at least the early 2030s. Rules aimed at lessening climate pollution from transportation, the nation's No. 1 source, are also on the Trump hit list. Meanwhile, the GOP megabill lumbering through the Senate would dismember former President Joe Biden's other huge climate initiative, the 2022 law that sought to use hundreds of billions of dollars in tax breaks and other incentives to encourage consumers and businesses to switch to carbon-free energy. At the same time, Trump's appointees have spent months shutting down climate programs, firing their workers and gutting research into the problem, while making it harder for states such as California to tackle the issue on their own. The years of whipsawing moves have left Washington with no consistent approach on how — or whether — to confront climate change, even as scientists warn that years are growing short to avoid catastrophic damage to human society. While the Trump-era GOP's hardening opposition to climate action has been a major reason for the lack of consensus, one former Democratic adviser said her own party needs to find a message that resonates with broad swaths of the electorate. 'There's no way around it: The left strategy on climate needs to be rethought,' said Jody Freeman, who served as counselor for energy and climate change in President Barack Obama's White House. 'We've lost the culture war on climate, and we have to figure out a way for it to not be a niche leftist movement." It's a strategy Freeman admitted she was 'struggling' to articulate, but one that included using natural gas as a 'bridge fuel' to more renewable power — an approach Democrats embraced during the Obama administration — finding 'a new approach' for easing permits for energy infrastructure and building broad-based political support. As the Democratic nominee in 2008, Obama expressed the hope that his campaign would be seen as 'the moment when the rise of the oceans began to slow and our planet began to heal.' But two years later, the Democrats' cap-and-trade climate bill failed to get through a Senate where they held a supermajority. Obama didn't return to the issue in earnest until his second term, taking actions including the enactment of a sweeping power plant rule that wasn't yet in effect when Trump rescinded it and the Supreme Court declared it dead. Republicans, meanwhile, have moved far from their seemingly moderating stance in 2008, when nominee John McCain offered his own climate proposals and even then-President George W. Bush announced a modest target for slowing carbon pollution by 2025. EPA Administrator Lee Zeldin contended Wednesday that the Obama- and Biden-era rules were overbearing and too costly. 'The American public spoke loudly and clearly last November: They wanted to make sure that all agencies were cognizant of their economic concerns,' he said when announcing the rule rollback at agency headquarters. 'At the EPA under President Trump, we have chosen to both protect the environment and grow the economy.' Trump's new strategy of ditching greenhouse gas limits altogether is legally questionable, experts involved in crafting the Obama and Biden power plant rules told POLITICO. But they acknowledged that the Trump administration at the very least will significantly weaken rules on power plants' climate pollution, at a moment when the trends are going in the wrong direction. Gina McCarthy, who led EPA during the Obama administration, said in a statement that Zeldin's rationale is "absolutely illogical and indefensible. It's a purely political play that goes against decades of science and policy review." U.S. greenhouse gas emissions were virtually flat last year, falling just 0.2 percent, after declining 20 percent since 2005, according to the research firm Rhodium Group. That output would need to fall 7.6 percent annually through 2030 to meet the climate goals Biden floated, which were aimed at limiting the rise in global temperatures to 1.5 degrees Celsius since the start of the Industrial Revolution. That level is a critical threshold for avoiding the most severe impacts of climate change. Those targets now look out of reach. The World Meteorological Organization last month gave 70 percent odds that the five-year global temperature average through 2029 would register above 1.5 degrees. The Obama-era rule came out during a decade when governments around the world threw their weight behind blunting climate pollution through executive actions. Ricky Revesz, who was Biden's regulatory czar, recalled the 'great excitement' at the White House Blue Room reception just before Obama announced his power plant rule, known as the Clean Power Plan. It seemed a watershed moment. But it didn't last. 'I thought that it was going to be a more linear path forward,' he said. 'That linear path forward has not materialized. And that is disappointing.' Opponents who have long argued that such regulations would wreck the economy while doing little to curb global temperature increases have traveled the same road in reverse. Republican West Virginia Gov. Patrick Morrisey said he felt dread when Obama announced the Clean Power Plan in 2015. Then the state's attorney general, he feared the rule's focus on curbing carbon dioxide from power plants would have a 'catastrophic' impact on West Virginia's coal-reliant economy. 'It was really an audacious and outrageous attempt to regulate the economy when they had no power to do so,' said Morrisey, who led a coalition of states that sued the EPA over Obama's proposal. 'You can't take the actions that they were trying to take without going to the legislature.' Meanwhile, Congress has become harsher terrain for climate action. In May, House Republicans voted to undo the incentives for electric cars and other clean energy technologies in Biden's Inflation Reduction Act, the nation's most significant effort to spur clean energy and curb climate change. That same week, 35 House Democrats and Sen. Elissa Slotkin (D-Mich.) crossed the aisle and voted to kill an EPA waiver that had allowed California to set more stringent tailpipe pollution standards for vehicles to deal with its historically smoggy skies. California was planning to use that waiver to end sales of internal combustion engine vehicles in 2035, a rule 10 other states and the District of Columbia had planned to follow. The Supreme Court has added to the obstacles for climate policy — introducing more existential challenges for efforts to use executive powers to corral greenhouse gas emissions. In its 2022 decision striking down the Obama administration's power plant rule, the court said agencies such as EPA need Congress' explicit approval before enacting regulations that would have a 'major' impact on the economy. (It didn't precisely define what counts as 'major.') In 2024, the court eviscerated a decades-old precedent known as the Chevron doctrine, which had afforded agencies broad leeway in how they interpret vague statutes. Many climate advocates and former Democratic officials contend that all those obstacles are bumps, not barriers, on the tortuous path to reducing greenhouse gases. They say that even the regulatory fits and starts have provided signals to markets and businesses about where federal policy is heading in the long term — prodding the private sector to make investments to green the nation's energy system. One symptom is a sharp decline in U.S. reliance on coal — by far the most climate-polluting power source, and the one that would face the stiffest restrictions in any successful federal regulation to lessen the electricity industry's emissions. Coal supplied 48.5 percent of the nation's power generation in 2007, but that fell to 15 percent in 2024. Last year, solar and wind power combined to overtake coal for the first time. 'Regulation has served the purpose of moving things along faster,' said Janet McCabe, who was deputy EPA administrator under Biden and ran EPA's Office of Air and Radiation during Obama's second term. 'The trajectory is always in the right direction.' Freeman, who is now at Harvard Law School, said federal regulations plus state laws requiring renewable power to comprise portions of the electricity mix helped justify utility investments in clean energy. That, in turn, accelerated price drops for wind and solar power, she said. Clean energy advocates point to those broader market shifts, calling a cleaner power grid inevitable. 'There are people in each of these industries who wouldn't have taken the climate problem seriously and cleaner technology seriously, and invested in it, if it weren't for the pressure of the Clean Air Act and the incentives that more recently had been built into the IRA,' said David Doniger, senior attorney and strategist at the Natural Resources Defense Council. 'So policy does matter, even when it's not in a straight line and the implementation is inadequate.' But even if those economic trends continue — an open question given the enormous new power demand from data centers — it will not bring the U.S. closer to cuts needed to keep the world from overheating, multiple climate studies have concluded. And the greatest chunk of the emissions decline since 2005 comes from shifting coal to natural gas, another fossil fuel, which fracking made cheap and abundant. Biden's power plant rule, now being shelved by Trump's EPA, would have imposed limits on both coal-burning power plants and future gas-fired ones, requiring them to either capture their greenhouse gases or shut down. Staving off regulations may well keep coal-fired power plants running longer than anticipated to meet forecast demand growth, belching more carbon dioxide into the air. The Trump administration has even sought to temporarily exempt power plants from air pollution rules altogether and is trying to use emergency powers to prevent coal generators from shuttering. Without federal rules that say otherwise, power providers would also be likely to add more natural gas generation to the grid. Failing to curb power plants' pollution, scientists say, means temperatures will continue to rise and bring more of the floods, heat waves, wildfires, supply chain disruptions, food shortages and other shocks that cost the U.S. hundreds of billions of dollars each year in property damage, illness, death and lost productivity. 'I don't think the economics are going to take care of it by any means,' said Joe Goffman, who led the Biden EPA air office. 'The effects of climate change are going to continue to be felt and they're going to continue to be costly in terms of dollars and cents and in terms of human experience.' Some state governors, such as Democrats Kathy Hochul of New York and Gretchen Whitmer of Michigan, have vowed to go it alone on climate policy if need be. But analyses have shown state actions alone are unlikely to achieve the greenhouse gas reductions at the scale and speed needed to avoid baking in catastrophic effects from climate change. The Sierra Club, for example, has helped shutter nearly 400 coal-fired units across the U.S. since 2010 through its Beyond Coal campaign, which has argued the economic case against fossil fuel generation in front of state utility commissions. While Joanne Spalding, the group's legal director, said it can continue to strike blows against coal with that strategy, she acknowledged that 'gas is a huge problem' — and left no doubt that the Trump administration's moves would do damage. 'Given what the science says about the need to act urgently, this will be a lost four years in the United States,' she said.
Yahoo
16 minutes ago
- Yahoo
Stephen Miller Explicitly Ordered ICE Raid Home Depots
Stephen Miller explicitly ordered ICE to target Home Depot parking lots to arrest undocumented day laborers, a report alleges. The White House deputy chief of staff gave the order in late May, gloating in a meeting that he could leave ICE's D.C. headquarters and arrest 30 people outside the nearest Home Depot, sources told the Wall Street Journal. Miller, 39, is also said to have reminded top immigration officials they are not just targeting the 'worst of the worst' criminals, but anybody who is in the country illegally—even if that is their only alleged wrongdoing. 'Just go out there and arrest illegal aliens,' he said, according to the Journal. ICE officials appear to have heeded the White House's call. The Journal reported that ICE conducted an immigration sweep at a Home Depot on Friday in a predominantly Latino neighborhood of Los Angeles. The raid was among those that spurred widespread anti-ICE demonstrations and occasional riots in the city, which escalated after President Donald Trump activated the National Guard and deployed Marines against the wishes of Democratic California Gov. Gavin Newsom. Day laborers are known to use Home Depot parking lots to find work at locations across the country, often waving down contractors or homeowners as they exit the home improvement store. Home Depot has acknowledged the practice, but does not explicitly allow it. Some stores feature signage to make clear that soliciting work is illegal in their parking lots. MAGA influencers have seized on this practice by migrants and are now encouraging ICE to continue targeting Home Depot parking lots. 'I'd like to report the front entrance of @HomeDepot at 5 am,' said Laura Loomer on Wednesday, responding to a promotion for the Department of Homeland Security's tip line to report undocumented immigrants. 'Location: Every Home Depot in the U.S.' Recent Home Depot raids have occurred at a minimum of seven locations in California, according to the Journal, The Guardian, and NBC Los Angeles. This appears to have workers skiddish about finding work in their go-to spot. Martha Arévalo, the executive director of the Central American Resource Center of Los Angeles, told the Journal that Home Depot parking lots in Southern California, once filled with hundreds of willing workers, have dwindled down to a 'handful.' Home Depot spokeswoman Beth Marlowe told the Daily Beast that the Atlanta-based corporation is not working in conjunction with ICE and that it does not receive any advance notice of raids at or near its locations. 'We tell associates to report [raids] immediately and not to engage with the activity for their safety,' she said. 'If associates feel uncomfortable after witnessing ICE activity, we offer them the option to go home for the rest of the day, with pay.' ICE did not respond to emails from the Daily Beast. White House spokeswoman Abigail Jackson told the Beast in a statement, 'If you are present in the United States illegally, you will be deported. This is the promise President Trump made to the American people, and the administration is committed to keeping it.' Miller has reportedly orchestrated the Trump administration's immigration crackdown. In the same meeting he reportedly ordered ICE to target Home Depot locations, he also allegedly threatened to terminate officials if their arrest numbers did not rise significantly. Miller told ICE it needed an arrest total at or near 3,000 migrants per day. A plan, dubbed 'Operation At Large,' was implemented shortly after. It saw thousands of federal law enforcement officers and special forces, who don't typically assist with immigration, being activated to help ICE round up migrants accused of being in the country illegally. This supercharging of arrests resulted in several notable mishaps. That included ICE briefly detaining a U.S. Marshal in Arizona by mistake last week.
Yahoo
16 minutes ago
- Yahoo
After images of unrest comes the political spin, distorting the reality on the ground in L.A.
Driverless Waymo vehicles, coated with graffiti and engulfed in flames. Masked protesters, dancing and cavorting around burning American flags. Anonymous figures brazenly blocking streets and shutting down major freeways, raining bottles and rocks on the police, while their compatriots waved Mexican flags. The images flowing out of Los Angeles over nearly a week of protests against federal immigration raids have cast America's second most populous city as a terrifying hellscape, where lawbreakers rule the streets and regular citizens should fear to leave their homes. In the relentless fever loop of online and broadcast video, it does not matter that the vast majority of Los Angeles neighborhoods remain safe and secure. Digital images create their own reality and it's one that President Trump and his supporters have used to condemn L.A. as a place that is "out of control" and on the brink of total collapse. The images and their true meaning and context have become the subject of a furious debate in the media and among political partisans, centered on the true roots and victims of the protests, which erupted on Friday as the Trump administration moved aggressively to expand its arrests of undocumented immigrants. Read more: Newsom, in California address, says Trump purposely 'fanned the flames' of L.A. protests As the president and his supporters in conservative media tell it, he is the defender of law and order and American values. They cast their opponents as dangerous foreign-born criminals and their feckless enablers in the Democratic Party and mainstream media. The state's political leaders and journalists offer a compelling rebuttal: that Trump touched off several days of protest and disruption with raids that went far beyond targeting criminals, as he previously promised, then escalated the conflict by taking the highly unusual step of sending the National Guard and Marines to Southern California. Reaction to the raids by federal Immigration and Customs Enforcement agents and the subsequent turmoil will divide Americans on what have become partisan lines that have become so predictable they are "calcified," said Lynn Vavreck, a political science professor at UCLA. "The parties want to build very different worlds, voters know it, and they know which world they want to live in," said Vavreck, who has focused on the country's extreme political polarization. "And because the parties are so evenly divided, and this issue is so personal to so many, the stakes are very high for people." As a curfew was imposed Tuesday, the sharpest street confrontations appeared to be fading and a national poll suggested Americans have mixed feelings about the events that have dominated the news. The YouGov survey of 4,231 people found that 50% disapprove of the Trump administration's handling of deportations, compared with 39% who approve. Pluralities of those sampled also disagreed with Trump's deployment of the National Guard and U.S. Marines to Southern California. But 45% of those surveyed by YouGov said they disapprove of the protests that began after recent Immigration and Customs Enforcement actions. Another 36% approved of the protests, with the rest unsure how they feel. Faced with a middling public response to the ICE raids and subsequent protests, Trump continued to use extreme language to exaggerate the magnitude of the public safety threat and to take credit for the reduction in hostilities as the week progressed. In a post on his TruthSocial site, he suggested that, without his military intervention, 'Los Angeles would be burning just like it was burning a number of months ago, with all the houses that were lost. Los Angeles right now would be on fire.' In reality, agitators set multiple spot fires in a few neighborhoods, including downtown Los Angeles and Paramount, but the blazes in recent days were tiny and quickly controlled, in contrast to the massive wildfires that devastated broad swaths of Southern California in January. Trump's hyperbole continued in a fundraising appeal to his supporters Tuesday. In it, he again praised his decision to deploy the National Guard (without the approval of California Gov. Gavin Newsom), concluding: 'If we had not done so, Los Angeles would have been completely obliterated.' The Republican had assistance in fueling the sense of unease. His colleagues in Congress introduced a resolution to formally condemn the riots. 'Congress steps in amid 'out-of-control' Los Angeles riots as Democrats resist federal help,' Fox News reported on the resolution, being led by Rep. Young Kim of Orange County. A journalist based in New Delhi pronounced, based on unspecified evidence, that Los Angeles 'is descending into a full-blown warzone.' Veterans Affairs Secretary Douglas Collins suggested that the harm from the protesters was spreading; announcing in a social media post that a care center for vets in downtown L.A. had been temporarily closed. "To the violent mobs in Los Angeles rioting in support of illegal immigrants and against the rule of law,' his post on X said, 'your actions are interfering with Veterans' health care." A chyron running with a Fox News commentary suggested "Democrats have lost their mind," as proved by their attempts to downplay the anti-ICE riots. Many Angelenos mocked the claims of a widespread public safety crisis. One person on X posted a picture of a dog out for a walk along a neatly kept sidewalk in a serene neighborhood, with the caption: 'Los Angeles just an absolute warzone, as you can see.' In stark contrast to the photos of Waymo vehicles burning and police cars being pelted with rocks, a video on social media showed a group of protestors line dancing. 'Oh my God! They must be stopped before their peaceful and joy filled dance party spreads to a city near you!' the caption read. 'Please send in the Marines before they start doing the Cha Cha and the Macarena!' And many people noted on social media that Sunday's Pride parade in Hollywood for the LGBTQ+ community went off without incident, as reinforced by multiple videos of dancers and marchers celebrating along a sun-splashed parade route. But other activists and Democrats signaled that they understand how Trump's position can be strengthened if it appears they are condoning the more extreme episodes that emerged along with the protests — police being pelted with bottles, businesses being looted and buildings being defaced with graffiti. On Tuesday, an X post by Los Angeles Mayor Karen Bass reiterated her earlier admonitions: "Let me be clear: ANYONE who vandalized Downtown or looted stores does not care about our immigrant communities,' the mayor wrote. "You will be held accountable." Read more: ICE expands immigration raids into California's agricultural heartland The activist group Occupy Democrats posted a message online urging protesters to show their disdain for the violence and property damage. 'The moment violence or property damage begins, EVERY OTHER PROTESTER must immediately sit on the floor or the ground in silence, with signs down,' the advisory suggested. 'The media needs to film this. This will reveal paid fake thugs posing as protesters becoming violent. ….The rest of us will demonstrate our non-violent innocence and retain our Constitutional right to peaceful protest.' Craig Silverman, a journalist and cofounder of Indicator, a site that investigates deception on digital platforms, said that reporting on the context and true scope of the protests would have a hard time competing with the visceral images broadcast into Americans' homes. 'It's inevitable that the most extreme and compelling imagery will win the battle for attention on social media and on TV,' Silverman said via email. 'It's particularly challenging to deliver context and facts when social platforms incentivize the most shocking videos and claims, federal and state authorities offer contradictory messages about what's happening.' Dan Schnur, who teaches political science at USC and UC Berkeley, agreed. 'The overwhelming majority of the protesters are peaceful,' Schnur said, 'but they don't do stories on all the planes that land safely at LAX, either.' Though it might be too early to assess the ultimate impact of the L.A. unrest, Schnur suggested that all of the most prominent politicians in the drama might have accomplished their messaging goals: Trump motivated his base and diverted attention from his nasty feud with his former top advisor, Elon Musk, and the lack of progress on peace talks with Russia and Ukraine. Newsom "effectively unified the state and elevated his national profile" by taking on Trump. And Bass, under tough scrutiny for her handling of the city's wildfire disaster, has also gotten a chance to use Trump as a foil. What was not disputed was that Trump's rapid deployment of the National Guard, without the approval of Newsom, had little precedent. And sending the Marines to L.A. was an even more extreme approach, with experts saying challenges to the deployment would test the limits of Trump's power. The federal Insurrection Act allows the deployment of the military for law enforcement purposes, but only under certain conditions, such as a national emergency. California leaders say Trump acted before a true emergency developed, thereby preempting standard protocols, including the institution of curfews and the mobilization of other local police departments in a true emergency. Even real estate developer Rick Caruso, Bass' opponent in the last election, suggested Trump acted too hastily. 'There is no emergency, widespread threat, or out of control violence in Los Angeles,' Caruso wrote on X Sunday. 'And absolutely no danger that justifies deployment of the National Guard, military, or other federal force to the streets of this or any other Southern California City.' 'We must call for calm in the streets,' Caruso added, 'and deployment of the National Guard may prompt just the opposite.' Sign up for Essential California for news, features and recommendations from the L.A. Times and beyond in your inbox six days a week. This story originally appeared in Los Angeles Times.
