Changes in California’s Health Care Landscape Under Gov. Newsom
California’s health care system today might not meet the expectations of Governor Gavin Newsom, who campaigned vigorously for the role in 2017 and 2018. As the former mayor of San Francisco, Newsom advocated for a single-payer health care system, promising that everyone in the state would have health coverage.
During his campaign, he stated, “There’s no reason to wait on universal health care and single-payer in California. You have my firm commitment that I will lead the effort to get it done.” However, once in office in 2019, he faced significant budget challenges and some political resistance, causing him to step back from that single-payer vision. This shift disappointed many supporters, including the California Nurses Association, who had backed him based on this promise.
Instead, Newsom embraced the idea of “universal access,” which means that every Californian should be able to see a doctor, even if it doesn’t guarantee full coverage for everyone. As he enters the final year of his second term, his vision for a better health care system remains largely unfulfilled.
This year, California is facing a serious budget deficit. As a result, Newsom had to abandon the plan to expand Medi-Cal, the state’s Medicaid program, to low-income undocumented adults. Additionally, federal subsidies that many Californians rely on are set to end, which will force many off their insurance plans.
Despite these setbacks, Newsom has made some important achievements during his time in office, including capping insulin costs and expanding Medi-Cal coverage for various age groups without regard to immigration status. As he wraps up his term, several significant changes to health care policies are on the horizon.
Enrollment Changes for Undocumented Adults
Starting January 1, low-income undocumented adults aged 19 and older will no longer be able to enroll in Medi-Cal. However, those already enrolled can maintain their coverage as long as they renew it. Under Newsom, most undocumented residents were initially included in Medi-Cal, seen as a step towards more comprehensive health care access. The program has grown from about 13 million to nearly 15 million enrollees, partly due to pandemic-related sign-ups. However, with a $12 billion budget deficit, the state is scaling back its commitment to undocumented adults to save money.
Asset Test Reinstatement for Medi-Cal
Effective January 1, adults may be denied Medi-Cal based on their assets, such as savings or property. The asset limits are set at $130,000 for individuals and $195,000 for couples. This change follows the elimination of the asset test in 2024, which had pleased many advocacy groups. The Legislature has put limits in place that are less stringent than what Newsom originally proposed.
Changes in Dental Coverage
As of July 1, California will cut full dental coverage for undocumented adults aged 19 and older, allowing only emergency services. Children and pregnant individuals will still have access to comprehensive dental care. This move is reminiscent of 2009 when the state cut nonemergency dental coverage for many adults but later restored it over time.
Reduced Insulin Costs
On a positive note, Newsom has introduced a new law that places a $35 cap on insulin prices for those with private insurance starting January 1. Additionally, insulin pens will be available through the state’s CalRx program for significantly lower prices, enabling better access for patients. Newsom emphasized that no Californian should need to struggle financially to obtain necessary medications.
As Newsom moves towards the end of his tenure, many goals remain out of reach. He must now focus on regaining some lost ground in California’s health care landscape, a difficult task that highlights the challenges of governance amidst shifting political and financial realities.
