In summary

Cuts in the May revised budget will result in more hospitalizations and higher mortality risks for California’s older adults.

By Linda Nguy and Claire Ramsey, Special to CalMatters

Linda Nguy is a health policy advocate at Western Center on Law & Poverty, Claire Ramsey is a senior staff attorney at Justice in Aging, They wrote this commentary for CalMatters.

No one expected good news when Gov. Gavin Newsom announced the May Revision of the California budget. As the COVID-19 pandemic obliterates plans and economies, there was no expectation that California’s budget would go unscathed. 

However, we never predicted the biggest blow would go to California’s older adults.

California still has the 5th largest economy in the world, so we hoped the budget revision would include new methods of investment for the health of our communities, like what was recommended by the California Senate. Unfortunately, that’s not what the May Revision proposed.

Adults age 65 and over make up more than 76% of the deaths from COVID-19 in California – black and Latinx older adults are particularly at risk. Yet the governor’s budget proposal makes sweeping cuts to the services and supports that keep these groups healthy, safe and living in our communities.

During a public health crisis like this, few things are more important than making sure people can access health care. But somehow in the budget revision, it’s health care that gets the biggest cut; and not just health care for anyone – it cuts health programs that older adults with low incomes rely on.

Despite the fact that at least one-third of all COVID deaths occur in nursing homes and assisted living facilities, the governor proposes to completely eliminate two programs, Community Based Adult Services and Multi-Purpose Senior Services Program, that allow older adults to live safely at home. The budget also proposes across the board cuts to the In-Home Supportive Services program. These cuts will result in more hospitalizations, more institutionalization and higher mortality risks for California’s older adults.

At the same time, the governor’s budget proposes to strip away vital Medi-Cal benefits for older adults – eyeglasses, hearing aids, necessary dental services and physical therapy, to name a few. These benefits were cut in the last recession, and it took advocates more than 10 years to get them back. For those who remember what happened during the last recession, the pattern is clear – gut services for older adults first, restore them last and gut them again whenever state finances look bad.

The cuts highlighted here are only the tip of the iceberg. The governor’s budget proposal also includes reinstating the senior penalty, which makes it harder for older adults to qualify for free Medi-Cal; cuts senior nutrition and elder abuse prevention programs; and reinstates Medi-Cal estate recovery rules, which penalize people who need Medi-Cal for health insurance, and causes reverberations beyond stripping older adults of health care.

Estate recovery is particularly troubling because it prevents people from enrolling in Medi-Cal for fear of the state taking their home when they die, leaving nothing to pass to their children. For all of the talk of #CaliforniaForAll, estate recovery exacerbates existing race and class disparities in intergenerational wealth by targeting people with low incomes and disrupting their potential to pass wealth to their loved ones. The last thing we need in the midst of the economic fallout from the pandemic is the return of this punitive rule.

Together, these cuts threaten the health not only of California’s older adults, but of everyone in our communities. Our parents, grandparents and neighbors will lose the services and supports that allow them to live safely in their communities.

These are fellow Californians who, in spite of being at high risk for complications from COVID-19, will have harsher income limits for accessing Medi-Cal. They helped build California’s economy – the one that fails them time and time again while bolstering those with higher incomes – but they can’t count on the richest state in the country to consider their health and well-being in a pandemic.

Older Californians are not expendable. They are vital members of our families and communities who built a state strong enough to weather this storm. The governor and the Legislature need to come up with a final budget that respects and protects them.


Linda Nguy is a health policy advocate at Western Center on Law & Poverty, Claire Ramsey is a senior staff attorney at Justice in Aging, They wrote this commentary for CalMatters.

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