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Editorial: California Medi-Cal measure locks in special-interest funding

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Editorial: California Medi-Cal measure locks in special-interest funding


 

Proposition 35, the Medi-Cal funding measure on the Nov. 5 ballot, presents another example of special-interest ballot-box budgeting that limits the discretion of lawmakers and reduces flexibility to respond to fiscal crises. Voters should reject it.

If we’ve learned anything in the past few years, it’s that multibillion budget surpluses one year can morph into gigantic deficits the next. The governor and state lawmakers need flexibility to responsibly address the shortfalls.

California voters should not lock in funding allocations that favor doctors and hospitals over children and community health workers. Nor should they keep tying the hands of lawmakers, who must already contend with, for example, voter mandates for school funding, which must receive about 40% of the state budget; for prudent budget reserves; and for arts education.

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At issue with Proposition 35 is a tax on health plans that provides $7.5 billion of the $161 billion needed to annually fund Medi-Cal — the federal-state health program for low-income people.

The tax is based on the number of people to whom the health plans provide coverage. The state leverages the tax money for matching funds from the federal government.

Medi-Cal, in turn, reimburses the health plans for almost all the tax, with the federal government covering the majority of the cost. In other words, it’s a tax that’s not really a tax but rather a way to pull in more federal money.

Proposition 35 is being sold as a measure that would secure that $7.5 billion in funding by permanently extending the tax on health plans. But this lock-in isn’t needed. State lawmakers, understanding how the tax leverages federal dollars, have generally levied and renewed it for nearly two decades and are incentivized to do so in the future.

Meanwhile, Proposition 35 would not only make the tax permanent, it would also dictate allocation of the spoils. It would pick winners and losers.

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Not surprisingly, the winners include doctors, hospitals and emergency ambulance providers, which explains why they are major financial backers of the measure. Their funding would be protected and, in some cases, increased under Proposition 35.

Among the possible losers are community health workers, private nurses and children under age 5, who are currently protected from losing their Medi-Cal coverage.

To provide the additional funding for the winners under Proposition 35 and still preserve other Medi-Cal programs, the state would need to tap the general fund for another $1 billion to $2 billion annually in 2025 and 2026, according to the Legislative Analyst’s Office.

The current tax will expire at the end of 2026 unless the Legislature and the federal government extend it. But there’s every reason to believe state lawmakers will do their part, just as they have in the past.

Yet, Proposition 35 backers tout that their measure would make the tax permanent starting in 2027 — and use the notion of going after politically unpopular insurance companies for money as a selling point even though those companies will get their money back.

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Backers of the ballot measure also say that the tax revenue has been diverted to bolster the state’s general fund. But the state this fiscal year will provide $62.4 billion to help fund Medi-Cal, including $35 billion from the general fund.

It’s fiscally reckless to keep using ballot measures to earmark unpredictable state revenues. Proposition 35, which is 43 pages long, “hamstrings our ability to have the kind of flexibility that’s required at the moment we’re living in,” says Gov. Gavin Newsom.

He’s right.

More funding for health care for the poor is a laudable goal. So are attempts to raise rates for doctors and other health care providers who serve Medi-Cal patients. Indeed, there are legitimate concerns about Medi-Cal patients not being able to find providers because doctors don’t want to take them on at low payment rates.

But the allocation of limited general fund money should be made when all the competing demands are weighed by state lawmakers. We shouldn’t be locking it in with a ballot measure few voters will ever understand.

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Live Updates: Candidates face off in the CBS News California and San Francisco Examiner Governor’s Debate

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Live Updates: Candidates face off in the CBS News California and San Francisco Examiner Governor’s Debate


 

Learn more about candidates’ stances on the issues in the California Governor’s Race interactive guide

CBS News California launched an interactive tool to help voters navigate this year’s gubernatorial race. The California Governor’s Race Candidate Guide features 20 hours of interviews with top-polling candidates to provide voters the opportunity to compare each candidate’s responses side-by-side on the issues that matter most to them.

Those running to succeed Gov. Gavin Newsom as California’s next chief executive offered their thoughts on more than a dozen issues, including homelessness, housing affordability, gas prices and environmental policy, immigration, healthcare, crime and public safety funding, and the state’s ongoing insurance crisis.

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Here’s what to know about the CBS News California/San Francisco Examiner Governor’s Debate format

The format of the CBS News California and San Francisco Examiner Governor’s Debate on Thursday will allow candidates to question each other directly. 

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Candidates will also participate in segments in which they address real-world issues California voters may face in their daily lives. The Californians who will be featured include a working single mother pursuing education; a couple struggling to achieve homeownership; and a scientist warning of the long-term consequences of inaction on climate change.

This structure for Thursday’s debate differs from the previous face-off hosted by CBS News California stations, which comprised three segments focused on affordability, accountability and social issues that lasted roughly half an hour each.

 
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Becerra, Hilton, Steyer lead field in latest polling on California governor’s race

An Emerson College poll released the day before the CBS News California and San Francisco Examiner Governor’s Debate showed Xavier Becerra leading the field with likely voters surveyed at 19%, followed by Steve Hilton and Tom Steyer both receiving 17%. Chad Bianco came in at 11%, followed by Katie Porter at 10%, Matt Mahan at 8%, Antonio Villaraigosa at 4% and Tony Thurmond at 1%. Twelve percent said they remained undecided.

In a CBS News/YouGov poll last month conducted before the April 28 CBS California Governor’s Debate, Hilton received support from 16% of likely voters polled, with Steyer and Becerra following at 15% and 13% respectively. Bianco came in at 10%, Porter received 9%, Matt Mahan and Antonio Villaraigosa both received 4%, and Tony Thurmond received 1%. The survey also found that a significant 26% of those polled were undecided.

California’s June 2 primary is an open primary where the top two vote-getters, regardless of party affiliation, advance to face off in the November general election. 

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Opinion | California will make less money from greenhouse gas emission auctions

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Opinion | California will make less money from greenhouse gas emission auctions


By Dan Walters, CalMatters

The Phillips 66 refinery in Wilmington, on Sept. 30, 2025. Photo by Stella Kalinina for CalMatters

This commentary was originally published by CalMatters. Sign up for their newsletters.

Two decades ago, when California got serious about reducing or even eliminating carbon dioxide and other greenhouse gases, its political leaders weighed two potential tactics about industrial emissions.

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The state could impose direct facility-by-facility limits, generally favored by climate change advocates. Or it could set overall emission reduction goals that would gradually decrease and auction off emission allowances, assuming their costs would encourage reductions.

The latter, known as cap-and-trade, was favored by corporate interests as being less onerous and was adopted, finally taking effect in 2012.

Since then, the California Air Resources Board has conducted quarterly auctions of emission allowances, collecting a total of $35 billion dollars so far, which, in theory, is being spent on projects that would reduce emissions.

The revenues have varied from year to year, but they have generally increased as the emission caps have declined. Since reaching a peak of $8.1 billion in the 2023-24 fiscal year, however, auction proceeds have been declining.

Roughly half of the money has been given to utilities to minimize cap-and-trade’s impact on consumer costs. However, the program has been widely criticized as a de facto tax on gasoline and other fuels, which were already among the most expensive of any state.

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The remaining revenues have been deposited into a Greenhouse Gas Reduction Fund that governors and legislators have tapped for various purposes, not all of them connected to emission reductions. In a sense, it’s been a slush fund.

Last year Gov. Gavin Newsom and the Legislature overhauled the program in two bills, Senate Bill 840 and Assembly Bill 1207. The program was extended, it was renamed as cap-and-invest and new priorities for spending auction proceeds were set.

Notably, the state’s cash-strapped and long-stalled bullet train project would get a flat $1 billion a year, rather than the 25% share it had been getting. Project managers hope that lenders will advance enough money to complete its first leg in the San Joacim Valley; the plan is to repay the loans from the $1 billion annual cap-and-invest allocation.

Early this year, the Air Resources Board released new regulations to implement the legislative changes but faced criticism that they would increase consumer costs. That led to a revision in April that softens the rules’ impact — most obviously on refiners who have been threatening to leave California — but environmental groups are very critical.

The April version would also sharply reduce net revenues from emission auctions, according to the Legislative Analyst’s Office, providing barely enough for the $1 billion allocation to the bullet train and another $1 billion for the governor and Legislature to spend. Other programs that have been receiving cap-and-invest support, such as wildfire protection and housing, would probably get nothing.

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The program has been tapped in recent years to backfill programs that a deficit-ridden state budget could not cover, so the projected revenue drop would exacerbate efforts by Newsom and legislators to close the state budget’s yawning gap.

“The (Greenhouse Gas Reduction Fund) is a relatively small portion of the overall state budget, but it has been a noteworthy source of funding for environmental and other programs in recent years,” the state Assembly’s budget advisor, Jason Sisney, says in an email. “Collapse of its revenues would change the state budget process noticeably. The state’s cost-pressured general fund seemingly would be unable to make up much, if any, of a significant (Greenhouse Gas Reduction Fund) revenue decline at this time.”

When Newsom presents his revised budget this week, he may reveal how he intends to cover the cap-and-invest program’s shortfall, particularly whether he will maintain the $1 billion bullet train commitment that project leaders say is vital to continuing construction of its Merced-to-Bakersfield segment.

It could boil down to bullet train vs. wildfire protection.

This article was originally published on CalMatters and was republished under the Creative Commons Attribution-NonCommercial-NoDerivatives license.

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Trump administration will defer $1.3B in Medicaid funds for CA

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Trump administration will defer .3B in Medicaid funds for CA


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Vice President JD Vance announced on Wednesday, May 13 that the Trump administration will be deferring $1.3 billion in Medicaid reimbursements from the state of California, as part of a new initiative to root out fraud in federal health programs.

The topic of California’s hospice care fraud has been a major focus of scrutiny by state leadership, members of President Donald Trump’s administration, and Gov. Gavin Newsom’s critics. In his announcement, Vance claimed that the administration was set on deferring these funds “because the state of California has not taken fraud very seriously.”

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“There are California taxpayers and American taxpayers who are being defrauded because California isn’t taking its program seriously,” Vance said during a press conference.

Notably, this decision was part of Vance’s Anti-Fraud Task Force’s plan to implement a six-month nationwide, data-driven moratorium on new Medicare enrollment for hospices and home health agencies.

The Centers for Medicare and Medicaid Services, which is led by Dr. Mehmet Oz, is set to use this six-month moratorium to conduct investigations and review data on Medicare programs, with the hopes of removing hospice and home health agencies that are suspected of committing fraud.

“Today we’re shutting the door on fraud — preventing new bad actors from entering Medicare while we aggressively identify, investigate, and remove those already exploiting them,” Oz said. “This is about protecting patients, restoring integrity, and safeguarding taxpayer dollars.”

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California Attorney General Rob Bonta called the administration’s action “unlawful” and noted that his office would be “carefully reviewing all available information” and may challenge the administration’s decision to threaten “Californians’ rights or access to critical services.”

“Once again, California appears to be targeted solely for political reasons,” Bonta said on X.

“The Trump Administration is planning to defer over $1 billion in Medicaid funding for vital programs that help seniors and people with disabilities remain safely in their homes.”

Bonta and his office have attempted to counteract criticism that the state does not take action against hospice fraud.

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In April, Bonta announced that the California Department of Justice had arrested five people in connection with a major health care scheme in Southern California that defrauded taxpayers of nearly a quarter of a billion dollars.

“For years, California has led the charge to protect public programs from fraud and abuse,” Newsom said in the press release on April 10. “We hold accountable to the fullest extent of the law anyone who tries to rip off taxpayers and take advantage of public programs, particularly those as sensitive as hospice care.”

Newsom has yet to publicly respond to the administration’s decision to defer California’s Medicaid reimbursement.

However, shortly after Vance made the announcement, Newsom’s press office blasted the decision on X.

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“We hate fraud. But that’s NOT what this is,” Newsom’s press office posted on X. “Vance and Oz are attacking programs that keep seniors and people with disabilities OUT of nursing homes. Pretty sick.”

Noe Padilla is a Northern California Reporter for USA Today. Contact him at npadilla@usatodayco.com, follow him on X @1NoePadilla or on Bluesky @noepadilla.bsky.socialSign up for the TODAY Californian newsletter or follow us on Facebook at TODAY Californian.



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