an entitlement established decades ago a policy decision that those at or near poverty should not go without medical care.
Brown administration officials said Tuesday they were surprised that 800,000 previously eligible recipients enrolled in Medi Cal last year, a number than exceeded their projections by more than 300,000.
Decisions will have to be made about whether to continue the entitlement, where to set the point of eligibility, how much taxes will be needed to pay for it.
During the lean years that beset California's budget for most of the last 14 years, one preferred way that elected officials chose to cut spending was to overwhelm the poor with paperwork.
In addition, millions of Americans parents with incomes between 106 percent and 138 percent of poverty guidelines, as well as childless adults with incomes below 138 percent of poverty became newly eligible for coverage.
That way, if she lost coverage for her family it wasn't the government's fault. Rather, it was hers for failing to maneuver her way through red tape. It was an effective way of curtailing the costs of an entitlement program.
With high unemployment, coupled with wages that are low and stagnant, 30 percent of Californians now qualify for Medi Cal.
either had never enrolled or had lost their coverage because they hadn't kept up with the paperwork.
An entitlement's actual cost
In many ways, the costs reflected in Brown's new budget simply reveal the actual costs of Hermes Belt Crocodile
As Gorell notes, that will create increasing challenges in the future as health care costs compete with schools, universities and other programs for general fund dollars.
They discovered they could trim hundreds of millions from state spending without actually having to overtly appear heartless. Rather than, for instance, take away government paid health insurance for a single mother with an income of $15,000, they would require her to fill out more demanding forms and to do it more frequently.
"This is not going to the middle class, it's not going to the rich," he said. "It's going to the people who are struggling the most."
may have noticed, that triggered a certain amount of public awareness of government administered and government run health care programs.
The result, Gov. Jerry Brown said Tuesday as Belt Gucci he released his revised state budget, is that Medi Cal costs have gone up $2.4 billion over two years. One reason for the magnitude of that increase, he noted, is that the federal government limited the amount of paperwork states could require recipients to complete to establish and maintain their eligibility.
"It was a real eye opener for me, for others and for the governor," said Assemblyman Jeff Gorell, the lead Republican on the Budget Committee. "The challenge we are going to have is with this unexpected growth in health care spending."
"People had been eligible but unenrolled for years," he said. "The state had been doing a good job of discouraging them, or at least not connecting with them."
In California, advertising paid for by charitable foundations and outreach by grass roots organizations combined to do a fairly effective job of spreading the word that there were new opportunities to obtain government paid health insurance.
Then came the Affordable Care Act.
Although Brown stressed that Medi Cal costs are now higher than anticipated, he also asserted that it's a good thing that so many who previously had not insurance are now covered.
And now California officials find themselves in a situation they hadn't quite anticipated. More than 3.6 million additional Californians are now enrolled in Medi Cal than had been just two years ago, a figure somewhat inflated by the fact that the previous Healthy Families program that provided coverage for kids was rolled into Medi Cal.
As you Hermes Belt Thin
Anthony Wright, executive director of the advocacy group Health Access, said the numbers should not be seen as a surprise, but rather "a correction."
Not surprisingly, those efforts reached not only those low income families who were newly eligible for Medi Cal, but also hundreds of thousands who were already eligible but Hermes Belt Horse
For all those who enrolled who were newly eligible, the federal government under the Affordable Care Act is picking up 100 percent of the costs. But for those who were already eligible but not enrolled, the costs are split 50 50 between the state and federal governments.
It was clear at the Capitol on Tuesday that the increasing costs of Medi Cal caught more than just administration officials off guard.
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