Latest news with #CaliforniaDemocrats
Medscape
24-06-2025
- Health
- Medscape
Federal Proposals Threaten Provider Taxes
Republican efforts to restrict taxes on hospitals, health plans, and other providers that states use to help fund their Medicaid programs could strip them of tens of billions of dollars. The move could shrink access to healthcare for some of the nation's poorest and most vulnerable people, warn analysts, patient advocates, and democratic political leaders. No state has more to lose than California, whose Medicaid program, called Medi-Cal, covers nearly 15 million residents with low incomes and disabilities. That's twice as many as New York and three times as many as Texas. A proposed rule by the Centers for Medicare & Medicaid Services, echoed in the Republican House reconciliation bill as well as a more drastic Senate bill, would significantly curtail the federal dollars many states draw in matching funds from what are known as provider taxes. Although it's unclear how much states could lose, the revenue up for grabs is big. For instance, California has netted an estimated $8.8 billion this fiscal year from its tax on managed care plans and took in about $5.9 billion last year from hospitals. California Democrats are already facing a $12 billion deficit, and they have drawn political fire for scaling back some key healthcare policies, including full Medi-Cal coverage for immigrants without permanent legal status. And a loss of provider tax revenue could add billions to the current deficit, forcing state lawmakers to make even more unpopular cuts to Medi-Cal benefits. 'If Republicans move this extreme MAGA proposal forward, millions will lose coverage, hospitals will close, and safety nets could collapse under the weight,' Gov. Gavin Newsom, a Democrat, said in a statement, referring to President Donald Trump's 'Make America Great Again' movement. The proposals are also a threat to Proposition 35, a ballot initiative California voters approved last November to make permanent the tax on managed care organizations, or MCOs, and dedicate some of its proceeds to raise the pay of doctors and other providers who treat Medi-Cal patients. All states except Alaska have at least one provider tax on managed care plans, hospitals, nursing homes, emergency ground transportation, or other types of healthcare businesses. The federal government spends billions of dollars a year matching these taxes, which generally lead to more money for providers, helping them balance lower Medicaid reimbursement rates while allowing states to protect against economic downturns and budget constraints. New York, Massachusetts, and Michigan would also be among the states hit hard by Republicans' drive to scale back provider taxes, which allow states to boost their share of Medicaid spending to receive increased federal Medicaid funds. In a May 12 statement announcing its proposed rule, CMS described a 'loophole' as 'money laundering,' and said California had financed coverage for over 1.6 million 'illegal immigrants' with the proceeds from its MCO tax. CMS said its proposal would save more than $30 billion over 5 years. 'This proposed rule stops the shell game and ensures federal Medicaid dollars go where they're needed most — to pay for healthcare for vulnerable Americans who rely on this program, not to plug state budget holes or bankroll benefits for noncitizens,' Mehmet Oz, the CMS administrator, said in the statement. Medicaid allows coverage for noncitizens who are legally present and have been in the country for at least 5 years. And California uses state money to pay for almost all of the Medi-Cal coverage for immigrants who are not in the country legally. California, New York, Michigan, and Massachusetts together account for more than 95% of the 'federal taxpayer losses' from the loophole in provider taxes, CMS said. But nearly every state would feel some impact, especially under the provisions in the reconciliation bill, which are more restrictive than the CMS proposal. None of it is a done deal. The CMS proposal, published May 15, has not been adopted yet, while the House and Senate bills must be negotiated into one and passed by both chambers of Congress. But the restrictions being contemplated would be far-reaching. A report by Michigan's Department of Health and Human Services, ordered by Democratic Gov. Gretchen Whitmer, found that a reduction of revenue from the state's hospital tax could 'destabilize hospital finances, particularly in rural and safety-net facilities, and increase the risk of service cuts or closures.' Losing revenue from the state's MCO tax 'would likely require substantial cuts, tax increases, or reductions in coverage and access to care,' it said. CMS declined to respond to questions about its proposed rule. The Republicans' House-passed reconciliation bill, though not the CMS proposal, also prohibits any new provider taxes or increases to existing ones. The Senate version, released on June 16, would gradually reduce the allowable amount of many provider taxes. The American Hospital Association, which represents nearly 5000 hospitals and health systems nationwide, said the proposed moratorium on new or increased provider taxes could force states 'to make significant cuts to Medicaid to balance their budgets, including reducing eligibility, eliminating or limiting benefits, and reducing already low payment rates for providers.' Because provider taxes draw matching federal dollars, Washington has a say in how they are implemented. And the Republicans who run the federal government are looking to spend far fewer of those dollars. In California, the insurers that pay the MCO tax are reimbursed for the portion levied on their Medi-Cal enrollment. That helps explain why the tax rate on Medi-Cal enrollment is sharply higher than on commercial enrollment. Over 99% of the tax money the insurers pay comes from their Medi-Cal business, which means most of the state's insurers get back almost all the tax they pay. That imbalance, which CMS describes as a loophole, is one of the main things Republicans are trying to change. If either the CMS rule or the corresponding provisions in the House reconciliation bill were enacted, states would be required to levy provider taxes equally on Medicaid and commercial business to draw federal dollars. California would likely be unable to raise the commercial rates to the level of the Medi-Cal ones because state law constrains the legislature's ability to do so. The only way to comply with the rule would be to lower the tax rate on Medi-Cal enrollment, which would sharply reduce revenue. CMS has warned California and other states for years, including under the Biden administration, that it was considering significant changes to MCO and other provider taxes. Those warnings were never realized. But the risk may be greater this time, some observers say, because the effort to shrink provider taxes is embedded in both Republican reconciliation bills and intertwined with a broader Republican strategy — and set of proposals — to cut Medicaid spending by $800 billion or more. 'All of these proposals move in the same direction: Fewer people enrolled, less generous Medicaid programs over time,' said Edwin Park, a research professor at Georgetown University's McCourt School of Public Policy. California's MCO tax is expected to net California $13.9 billion over the next two fiscal years, according to January estimates. The state's hospital tax is expected to bring in an estimated $9 billion this year, up sharply from last year, according to the Department of Health Care Services, which runs Medi-Cal. Losing a significant slice of that revenue on top of other Medicaid cuts in the House reconciliation bill 'all adds up to be potentially a super serious impact on Medi-Cal and the California state budget overall,' said Kayla Kitson, a senior policy fellow at the California Budget & Policy Center. And it's not only California that will feel the pain. 'All states are going to be hurt by this,' Park said.
Bloomberg
10-06-2025
- Politics
- Bloomberg
Violence Endangers California Democrats' Great Move to the Middle
State and city leaders blame Trump for the escalation. Plus: How Hampton Inn became the world's largest lodging brand. By Save Defense Secretary Pete Hegseth is taking questions today in Congress about the cost of deploying troops against protesters in Los Angeles. Businessweek Editor Brad Stone writes that there's also a political price to be paid, especially for California Democrats who have been moving toward the middle. Plus: Grab a waffle and read about Hampton Inn's rise, and a surprisingly juicy battle between two multibillion-dollar software vendors. Help us improve Bloomberg newsletters: Take a quick survey to share your thoughts on your signup experience and what you'd like to see in the future. If this email was forwarded to you, click here to sign up.
The Independent
09-06-2025
- Politics
- The Independent
How Trump just made Gavin Newsom's day by sending the National Guard to Los Angeles — politically, anyway
On Monday, California Gov. Gavin Newsom announced that he would sue President Donald Trump's administration for seizing control of the state's National Guard to quell immigration enforcement protests in Los Angeles. In response, Trump seconded his 'border czar' Tom Homan's threat that he might arrest the governor. 'I would do it if I were Tom,' Trump told reporters. Just the day before, in an interview with NBC News, Newsom had all but dared Homan to arrest him. The protests began late last week after Immigrations and Customs Enforcement agents conducted raids and arrests in Los Angeles at a Home Depot that resulted in 44 people being arrested. The move gave Newsom, who has never been able to conceal his aspirations for higher office, an incredible surge of media attention just after he received months of public derision. In truth, Trump's war on Los Angeles has given California's Democrats, who have long been beleaguered, a new life. While California has long been one of the biggest vote banks for the Democrats, in recent years, it has caused just as much heartburn for the party. During the Covid-19 pandemic, people fled the state given the high cost of living, though it has seen its population grow in the past two years. California also accounted for a quarter of all homeless people in the United States in 2024, according to a report from the Department of Housing and Urban Development. Newsom has always had a penchant for the spectacle, going back to his time as mayor of San Francisco, when he performed same-sex marriages when even Democrats like Barack Obama and Hillary Clinton publicly opposed marriage for gay couples. He relished debating Ron DeSantis, Florida's ultra-conservative governor, on Fox News and loves going on the network more than people might expect a Democrat from liberal San Francisco should. But he's also faced criticism in recent months for how he handled — or failed to get a handle on — the out-of-control wildfires earlier this year. He's also ruffled some Democratic feathers with his decision to chat with conservatives like former Trump adviser Steve Bannon and Turning Point USA founder Charlie Kirk on his podcast. When he spoke with Kirk, he said that allowing transgender athletes to compete in women's sports was 'deeply unfair,' which naturally angered progressives. But now, Newsom is in the place where he feels most comfortable, in a combative stance pushing back against the Trump administration. Like many other Democratic elected officials, he is weighing whether to jump into the 2028 presidential primary. If somehow Homan decides to slap some handcuffs, it would give Newsom potent fodder for voters in South Carolina and other early-voting primary states. The same can be said for Los Angeles Mayor Karen Bass. During the wildfires, Bass was actually not in Los Angeles, but rather in Ghana, which violated her campaign promise to Angelenos that she would not travel internationally while mayor. When a reporter grilled her about being absent during the worst fires in the city's history, she stayed silent. Bass' approval ratings plummeted in Los Angeles. And like many other cities with large Hispanic populations, Los Angeles shifted to the right in the 2024 election, though it remains firmly Democratic. This would put her in a difficult position going into Los Angeles's election in 2026, which has a top-two primary system where the two highest-vote earners in the primary advance to the runoff regardless of party. But Bass, in part fueled by Trump's federalizing the National Guard and sending them to her doorstep, has since pushed back to defend the city she leads. She has urged people to remain peaceful, saying: 'We do not want to play into the [Trump] administration's hands.' If Bass is seen as advocating for her city in a moment when its large immigrant population feels under siege, it could pay large dividends. Then, of course, there is Kamala Harris. In the months since Trump defeated the former vice president by winning the popular vote and all seven swing states, Harris has weighed whether to seek the governorship of the Golden State when Newsom's term expires or to take another go at running for the presidency. Over the weekend, she denounced Trump's escalation as 'part of the Trump administration's cruel, calculated agenda to spread panic and division.' Republicans have loved to beat up on California, a state they once dominated with luminaries such as Pete Wilson, Richard Nixon and Ronald Reagan. But if Trump and the GOP overstep their mandate, they risk a backlash and amplifying the very liberal politics and policies that they seek to quell, and might wind up making them stronger in the long run.
Fox News
02-06-2025
- Business
- Fox News
California Dem doubts someone from their state could win presidency since they're thought of as 'crazy people'
California Democrats at their annual state convention had mix feelings about whether someone from their state could win on a national level after former Vice President Kamala Harris lost in 2024. Delegates convened over the weekend with guests to induct new members and plan for the 2026 election season. Although Harris and California Gov. Gavin Newsom have both been seen as potential 2028 Democratic presidential contenders, neither appeared at the convention, with Harris only addressing the convention via video. The convention largely avoided discussions about the 2028 election, with at least one delegate wondering if a liberal Californian could win on the national stage at all. "I don't know if a California Democrat can win a presidential election," delegate Jane Baulch-Enloe told the Los Angeles Times. "California is thought of as the crazy people... I don't mean that in a bad way — though I know some people do — but we do things differently here." Baulch-Enloe instead insisted California Democrats first need to "get people on our side and help them understand that we aren't just wacko liberals and teach people that it's okay to want things" like higher wages or universal healthcare. Other attendees, such as Asian American Pacific Islander caucus leader Aref Aziz, argued that Democrats need to have a clearer perspective and message on the economy if they want to win more elections. "When you look at a lot of our economies, California and New York, by all accounts, GDP, the numbers that you look at, they're doing great," Aziz said. "But when it comes to the cost that consumers are paying in these places, they're so high and so far above other countries that we end up diminishing whatever value there is in our GDP, because everything's so expensive." However, not all delegates believed California's liberal policies would be a hindrance to future elections. "People like to point a finger somewhere, and I think California is an easy target, but I disagree," delegate Melissa Taylor told the LA Times. "Because I think that California is standing up for values that the Democratic Party believes in, like we believe in labor, we believe in healthcare, we believe in women's rights, we believe in rights for LGBTQ people." Jodi Hicks, the president of Planned Parenthood Affiliates of California, added that Harris' loss was prompted by multiple "unique" factors, including her short three-month campaign, rather than politics. However, she agreed Democrats need "to walk and chew gum at the same time" when it comes to promoting liberal policies and helping the economy. Fox News Digital reached out to the California Democratic Party for comment.
Fox News
02-06-2025
- Business
- Fox News
California Democrats uncertain about Kamala Harris' potential run for governor
Some California Democrats are unsure about former Vice President Kamala Harris launching a gubernatorial bid in her home state following her loss to President Donald Trump, according to reports. "I think she'd be fine. I mean, she's already been a state leader, right?" Denise Robb, a Democratic Party delegate from Pasadena, told the Washington Post. "It's just that she lost the presidential race and she's been almost — gone. We don't hear from her. We don't see her." The Post and The New York Times reported on Sunday that activists and delegates within the party weren't all in on the former vice president, who has held statewide office in California before as attorney general and a U.S. senator. Harris delivered a 3-minute video speech at a gathering of thousands of California Democrats over the weekend, with other gubernatorial candidates in attendance. "I don't think she should get into the campaign for governor," Mark Gracyk, a delegate from San Diego, told the Times. "The working class would say, 'Oh there she is again, she has the support of the elites.'" The former vice president has made a handful of public appearances since her 2024 election loss, including a speech that criticized Trump's first 100 days in office in early May. Amanda Day, a delegate from Merced, told the Post that her support for Harris in the 2024 election didn't automatically mean she would support the former VP for governor, should she choose to run. Day also noted that Harris' past as a state attorney general might cause a problem for her. "I liked her as a presidential candidate, but it was a different job," Day said. "Coming back to California is a whole other story. She has history here." Ayo Banjo, a delegate from Santa Cruz, told the Times that she wanted to understand where Harris stands right now. "I wonder where her priorities are, and where she's at right now," Banjo said. "I do support her and think that she's great, but right now I have more questions than answers." Former Democratic lawmaker Katie Porter, Lt. Gov. Eleni Kounalakis, former Los Angeles Mayor Antonio Villaraigosa, and former Health and Human Services Secretary Xavier Becerra are among the other Democrats who have launched a bid for California governor. Villaraigosa has charged that Harris and Becerra, who both served in the Biden administration, were involved in a cover-up of Biden's decline while in office, citing the new book, "Original Sin," which delves into the scandal. "Now, we have come to learn this cover-up includes two prominent California politicians who served as California Attorney General – one who is running for Governor and another who is thinking about running for Governor," he said in a statement. "Those who were complicit in the cover-up should take responsibility for the part they played in this debacle, hold themselves accountable, and apologize to the American people. I call on Kamala Harris and Xavier Becerra to do just that – and make themselves available to voters and the free press because there's a lot of questions that need to be answered," Villaraigosa continued. Harris is set to decide her next move by the end of the summer. Former Vice President Harris did not immediately respond to a request for comment from Fox News Digital.
