It was bad enough when California was looking at a $9.2 billion budget deficit. But a recent update upped that estimate to almost $15.7 billion, and now Gov. Jerry Brown is proposing even deeper cuts.


The May revision includes about $2.5 billion in cuts for services to kids, seniors and the disabled.


“It’s a body blow to the health care system we all rely on,” says Anthony Wright, executive director of consumer advocacy coalition Health Access California. The proposed cuts compound the $15 billion slashed from health and human services in recent years, he adds.


Among the hardest hits: More than $400 million in cuts to hospitals, nursing homes and clinics; a shift to managed-care plans for 1.1 million “dual-eligible” seniors and disabled people with both Medicare and Medi-Cal benefits, saving $663.3 million in 2012-13; and the transfer of 875,000 children in the Healthy Families program into Medi-Cal, saving $48.6 million. 


That’s all assuming voters approve $8.5 billion in new taxes in November. If the ballot measure fails, the cuts will be worse.


But Alan McKay, executive director of the Central California Alliance for Health, says many of the proposed cuts could go down in debate. “It’s one thing to look at the governor’s proposal, but it’s another thing to look at what’s playing out in the Legislature,” he says.


McKay thinks some of the proposed reforms, like streamlining services for dual-eligible patients, make a lot of sense. “It’s unfair to the elderly and the disabled have to navigate [Medicare and Medi-Cal] separately,” he says. “Done right, I think there could be less confusion and better outcomes with an integrated approach.”


He’s more skeptical of the governor’s move to cut Healthy Families and transfer its beneficiaries to Medi-Cal, because similar changes are already on the horizon under the federal Affordable Care Act. There are about 18,000 Healthy Families members in Monterey County.


Brown’s proposal to reduce staff hours for in-home supportive services could push more elderly and disabled patients into costly nursing homes. “It’s one of those cases where the state is working against itself,” McKay says.


Assemblyman Bill Monning, D-Carmel, says he expects the Legislature to reject some of the cuts. Finding revenue sources to replace them, though, is harder. “My commitment is to try to minimize impacts to the most vulnerable,” he says. “It’s not like there’s a secret pile of money that we’re holding back. There is no money.”


The May revision includes built-in triggers for even more cuts if voters reject the November tax measure. “Gov. Brown has been absolutely resolute since he was a candidate that he would not seek any revenue increase without going to voters,” says Monning, who’s on the budget and health committees.


The Legislature has until June 15 to present a balanced budget. Since the passage of 2010’s Proposition 25, cuts only need a simple majority to pass; but revenue hikes still need a two-thirds supermajority. 


“If those votes aren’t there – we don’t expect that they are – [the budget] will be balanced predominantly by cuts,” Monning says.


The federal Affordable Care Act, meanwhile, is set to expand healthcare coverage nationwide in 2014. Monning is authoring legislation to implement it in California. “On the one hand we’re cutting,” he says, “and on the other we’re preparing for expanded care.” 


County Department of Social Services reps address the state budget impacts 5:30pm Wednesday, May 30, at Oldemeyer Center, 986 Hilby Ave. Free. 883-7570.