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Senate Budget and Fiscal Review Committee California State Senate
Follow its sittingsSpeaker 1
Thank you. And before I ask the legislative analyst if there are any additional comments, a quorum has arrived. So would you please call the roll?
Speaker 3
Senators Laird? Here. Nilo? Here. Archuleta?
Here. Lakespeare? Here. Cavaldon? Here.
Choi? Here. Duraso? Here. Grove?
Hurtado? McNerney?
Speaker 1
have a quorum. Thank you very much. And let me ask if you have any comments you would like to make.
Speaker 4
Carolyn Chew from the Legislative Analyst Office. Nothing to add, but happy to answer questions.
Speaker 1
have questions or comments from committee members? Pardon? I have a motion from Senator D'Araso. Was that Okay. A question from Senator Ochoa Boak.
That the extent of the presen
Speaker 7
Okay. Thank you So so a couple of questions. I'm kind of curious. So it's my understanding that the original proposed governor's report or budget proposal had a $60,000,000 general fund for these clinics. And then this particular trailer bill has come in at 90,000,000 appropriation.
What is the rationale behind that increase?
Speaker 4
Yes. So at the time, the 60,000,000 was based on information, point of time information. And since then, we've had more conversation and have been provided more data. So that number has gone has changed from $60,000,000 to $90,000,000
Speaker 4
This data was from providers that would be eligible for this. So, Planned Parenthood is one of those providers. What's another provider? I believe we've been in discussions with Planned Parenthood specifically.
Speaker 7
Okay. So we don't have any other qualified providers that have been listed as providing this information. It's been Planned Parenthood solely?
Speaker 8
It's Sanal Patel with the Department of Finance. So we are aware of Planned Parenthood's, you know, the situation with respect to HR one. And as you'll know, in the provisional language, it does outline a grant distribution process so that if there are other applicants that meet the requirements, they could, in theory, apply for and be eligible for grant funding.
Speaker 8
Pursuant to the provisional language. The Department of Health Care Access and Information would establish a grant program which would detail the methodology, the eligibility criteria. And then once they put this out for the public to apply for providers, it would detail what those were. So we don't have the specifics of what the grant program would be, but this is pretty consistent with other grant programs in terms of the department would develop the methodology and explain what the criteria is for applicants.
Speaker 7
Okay. So I'm kind of curious now, as we've been talking about the different grant programs and money going towards a grant program. So curious. We know that many hospitals are currently struggling, especially in rural areas like mine. There's many hospitals that literally are either closing their labor and delivery rooms.
Are maternity warders that literally don't have any money at their closing. So we have folks that are traveling to deliver babies two to three hours, four hours, depending on where they live. That's incredibly difficult for them. And we have approved a loan program for some struggling hospitals in California loans, not grants. How did you folks determine the fact that grants would be available for these clinics, but not a loan to get them through?
Because that's what we did to these hospitals that are closing these maternity wards. They're not grants. So why the difference there? How did you folks determine that these hospitals with these closing maternity wards are getting loans but not grants, and these clinics are getting grants.
Speaker 8
So, in this scenario, these are providers that would have otherwise been eligible for state funding through the Medi Cal program. These are Medi Cal providers who have been impacted by the federal prohibition. In this scenario, we understand there's
Speaker 8
We understand that there are bigger sort of budget questions and pictures that we will continue to construe with, but these are providers that would have otherwise been eligible for funding. And that's what went into the
Speaker 7
decision making process. But why a grant and not a loan, per se? Because these I'm sure these rural hospitals would also qualify, but they're not getting they don't have the luxury of getting a grant. They're getting loans.
Speaker 8
I think it's a scenario. These are not providers that would have otherwise received any kind of federal funding. This is a bit of a unique scenario, as was mentioned by the chair, that this prohibition on federal Medicaid dollars went into effect on July 4 for providers that were otherwise already eligible and will, receive eligibility again on 07/04/2026. So I do think there's a little bit of a distinction here in the type of provider versus what you've explained with the hospitals who are not otherwise eligible, who do have financial distresses but who are not otherwise eligible for this federal funding due to the loss of prohibition. So that did go into our decision making process, and it doesn't it doesn't speak to, like, the fact that there isn't a separate situation, but we do need to address the issue happening that's resulting in these family planning providers not being eligible for any federal funding at all.
Okay. But
Speaker 7
the money is following the patient, right? I mean, the prohibition is coming following the patient. So the patients are also that are being impacted in these rural areas, I'm assuming.
Speaker 8
The prohibition is on providers. If if you meet so the definition of a prohibited entity pursuant to HR one is that you made you received over a certain threshold of dollars in a specific fiscal year, and you provide abortion. So it follows it's actually at the provider level, not at the patient level. Okay.
Speaker 7
And then the other question that I had for it is so according to my notes, the state had already set aside $146,000,000 for Planned Parenthood in the current budget year. So can you describe why this existing money is insufficient to cover these clinics until July?
Speaker 8
So as chief deputy director Lee mentioned, our data is constantly being updated based on point in time, and this additional augmentation reflects the needs of the data. It's an alignment with the data. These are all current year adjustments.
Speaker 7
Okay. Because I just wanna I wanna make sure that we highlight and we put it on record. Let me see. Where do I have this? Sorry.
There's a lot of notes here. Okay. So what I have here is that so the 90,000,000 that you folks are proposing in this budget trailer bill is in addition to the $146,000,000 in special funds paid by managed care plans, already in the current 'twenty five and 'twenty six budget that provides direct funding to abortion providers. And that 90,000,000, 90,000,000 in managed care organization, MCO, tax, and a 56,000,000 in the abortion access fund. So together here, it's about $236,000,000.
And some of the concerns that I have with this is the fact that, once again, going back to our hospitals that are struggling, we've provided loans, not grants, at a fraction of that amount. And not only that, but also the fact that, right now, within that budget for 2025, it included a $45,000,000 permanent general fund cut to the self determination program at the Department of Developmental Services. So here we are adding all of these additional funding, which is over, what was it, $236,000,000 while we're cutting funding to folks who are literally disabled in our state and taking away permanent I mean, it's it's a permanent cut from my understanding it. And I'm just trying to figure out the logic behind that. These are folks that cannot help themselves.
And yet, we're doing permanent cuts here and then allowing not 60, but 90,000,000 now with the new proposed budget. I think it's important for the public to be aware of where the priorities are for the state, as far as our disability, groups that are disabled, our people that are disabled, our citizens who really, really need our help. We are their safety net. Thank you.
Speaker 1
I am going to take the liberty of asking a follow-up question or maybe series of questions to clarify what the matter is in front of us. HR1 had only one cut that went into effect with the signing of the bill. The others were delayed. And there was an impact to California for these clinics. And my understanding is it was in the neighborhood of $335 to $350,000,000 Do you know what that number is?
That is the reduction.
Speaker 1
going to ask a follow-up question that goes to the pieces of that, I'm going to clarify what the situation is.
Speaker 4
Right. But I also want to clarify that, as noted, this is the immediate impact of HR1 on the clinics. There was funding already in
Speaker 1
the I'm about to get there. I'm trying to establish what the total amount of the problem is because it was represented that the problem was $90,000,000 and the total problem that was the cut to California was somewhere around $335,000,000 I'm just trying to get you to say yes to a number.
Speaker 4
can get you the exact number. But it is higher, yes, it is higher than the $230,000,000 that is So
Speaker 1
we are dealing with a $335,000,000 cut. Now, there have been different pieces of how we fill in against the $335,000,000 There was some money from proposition 30 I'm not sure if that was the precise that was referred to. But the governor did $180,000,000 I think, and $290,000,000 tranches. I don't know if that I think that was a different one. Then from the MCO there was $55,000,000 and then $10,000,000 in the year.
And then if we appropriate $90,000,000 here, we get close to the $335,000,000 cut. Is that framework generally the framework that we are dealing with here?
Speaker 4
That is correct. And it's also, again, based on conversations that we have had with Planned Parenthood in particular about their loss of federal funding.
Speaker 1
But this isn't like a piecemeal thing. This is using different funds over these different things to make up what the cut was so that this isn't like restoring other programs. We are trying to restore the one cut here that was the one immediate cut to California.
Speaker 1
Okay. I'm just trying to establish that because it sounded like it was an incremental thing, and it is incremental in how we get to the total number that is the cut that California experienced.
Speaker 1
Okay. And now I have a list. Smallwood Cuevas, Choi, Sarto, Kabalton, and eventually Nilo. Is there anybody else? Oh, I'm sorry.
Menjivar. Pearson. Weber Pearson.
Speaker 11
Thank you for the clarification, mister chair. And, the one thing I can say, in this moment is this is not an accident that we are here having to make this choice. This is an intentional attack on women. It's an intentional attack on the rights of young women's future here in this country. It's an intentional attack on our budget, which we are, as you so appropriately stated, the cuts seem to be higher and higher and are accumulating in a way that is putting our state in a fiscal crisis.
As a member who represents South Central Los Angeles, right on the border Planned Parenthood just a couple of years ago opened a much needed health care clinic in our community that is serving some of our most vulnerable seniors, teens, mothers, and these drastic cuts have them on the brink of of closure. At the same time, we already have heard the announcement of over a dozen clinics being closed because of HR one in our area. There are slated 1,300 layoffs that are now being planned in our area because of HR one, and that is the very first, I want to say, tranche of impact that we're going to have to deal with. So, you know, I'm here, obviously, to support this rapid response emergency action that we have to take today, but we know this is not going to be the only response that we're going to have to take. We're going to be here time and time and time again, whether it's women's rights, whether it's dealing with our universities and research, whether it's dealing with nonprofits who have had their HIV for black men cut, or black women for wellness who are trying to get much needed care, whether it's support services for immigrants.
This is a disaster, and it's an intentional attack on our communities. It's an intentional attack on our values. And I'm voting, obviously, in support of this, but I wanna say, it's under great duress that we have to be here taking these kinds of votes and spending our time on these kinds of emergency actions. And so I, appreciated the chair's correction. We're putting a Band Aid on a gaping wound, And unfortunately, there are so many wounds that we're gonna have to try to care for over these coming months.
Speaker 12
Thank you, chair. I would like to register my opposition for two major reasons. Rather than a specific amount of money, which $90,000,000 is not a small amount of money. But there are so many other urgent, more important areas as a policy you can set rather than spending $90,000,000 for abortion clinics. So when we talk about the medical care, there are all kinds of different kinds of medical cares.
To me, abortion issue is not that priority over such as prenatal care for pregnant women and then also helping closing rural area hospitals. There are so many issues, even criminal issue supporting prop 36, it can be another priority. Fire prevention can be disasters, fires every year we experience. There are so many pressing areas that we can specifically illustrate one one by one. But abortion clinic is not that the priority as I hear that is the woman's right.
It's not caring about their concerns. There are so many different areas about the in determining important policies. There has to be priorities. What is more important issues in spending money? And then also this $90,000,000 comes from general fund when our budget is unstable.
And in coming years, we are expecting so big deficits. Is it really necessary to spend $90,000,000 from the general fund? Secondly, this particular issue is also suggesting this bill, AB one zero six, is suggesting exempting the grants that we are about to consider is exempting from the Public Records Act. Why there has to be pro waiving exempting public rights actors. Nothing to do with this spending money.
And who's gonna get this money? I has to be clear record. Who would like to analyze how the money was spent, that should be open to the public. Trans transparency is a big issue. So this bill is presenting two different troubling areas.
For these reasons, I don't think I can support this bill.
Speaker 13
Thank you very much. I just have a couple of questions. One is kind of in line with doctor Troyes. Why are we waiving Why are we waiving the Public Records Act for contracts and things like that? That's all about transparency, and supposedly we're all about transparency nowadays.
Speaker 4
So, on your question about the contract exemption, I think as we are here not soon after the governor's budget was released for an early action to respond to something that is an urgent need, and so the contract exemption will allow for those dollars to get out sooner. In terms of the Public Record Act exemption, I think we are sensitive to important health and reproductive health information being available. Simply put, the need for additional protections was necessary. This is not setting a precedent. We've done something similar with the Abortion Access Fund program as well.
And so, I would just cite that those for those two reasons, you see the contract exemption as well as the EPA Right.
Speaker 13
Kind of exemptions create the perception, if it's not reality, and there's probably reality in it, that it kind of sets up programs for a lot of fraud and abuse. And we have no way of tracking it. We have no way of exposing it. So when I see waivers of things like that, I'm thinking, you know what, we're probably waiving that so people don't get to look at it and therefore criticize the program. So my second question is about, you know, I've heard about the data says the data says.
What's the data and what's driving that data? Is it usage? Is that what the data is? How many people are accessing the programs that we created for abortion clinics to do their thing? Is that what it is?
Speaker 10
Laura Aiella, Department of Finance. The data that we have is from the Department of Health Care Services, and it's based on claims for the current fiscal year and the prior fiscal year, and that's how we estimated what was previously included in the budget act and what we're proposing to fund now.
Speaker 13
So the number of claims exceeded what we were thinking they were going to be. Is that No.
Speaker 10
The 2025 Budget Act includes funding, and reproductive health providers are not able to access that funding because of the HR1 prohibition.
Speaker 13
But we went from 60 to 90, and I was just told that the reason we have 90 is because new data has sowed us, and that new data is how many people are accessing the services.
Speaker 13
data. Okay. So, two years ago, I believe it was two years ago, we passed a bill that invited people from other states to come on over and we'll give you our free services here in California for California taxpayers to pay for. Is that part of that? Is that part of that data?
Speaker 10
The data is based on actual claims that the Department of Health Care Services has received.
Speaker 13
Okay. And the claims are from where? Are they from all California citizens or are they from people from other states? Are they from people that are not citizens? Where is the data coming from?
Speaker 13
Thank you. That's all we need to get at. I have a problem with that. And the problem isn't, you know, we've already discussed the policies of abortion stuff. It's how come Californians get stuck with the bill for everybody else?
It's not even in California. But we're inviting them here to take advantage of our free service that's not free. We pay for it. And if that's our policy, then I absolutely don't agree with it. There's a reason the hospitals are going under.
It's over usage and underpayment. And and basically, we have invited that into our system. And now we're paying for it. And now we wanna keep going down that road and keep paying for it. So you've you've basically answered all I need to know about what we're doing here.
And and I think people should be alarmed because if we're going to keep going down that path and everybody's getting free free coverage over here, why not everybody come here? From the entire United States come over and have California taxpayers pay for their procedures, whether they're elective or not? It's wrong. Thank you.
Speaker 14
Thank you, Mr. Chair, and thanks to the administration and our leadership here in the Senate for working so hard to get this before us. You know, there was no Defund Hospitals Act introduced into the Congress in 2025. There was no Defund Rural Hospitals. The only actual proposal that named anything that made it into HR1 was Defund Planned Parenthood by name, specifically defund Planned Parenthood.
It wasn't even defund abortions because as we all know, the Hyde Amendment already precluded the federal government from funding abortions directly. So that's not what this is about. By the way, of course, in California, the voters overwhelmingly chose to to take the very rare action of amending the constitution to protect the right of Californians to access abortion, not just as a theoretical civil right, but by having clinics available to make that right real. And so this was a direct attack on Planned Parenthood as an organization to say, no, even though Planned Parenthood clinics, most of what they do and at least for my constituents, most of what people depend on Planned Parenthood clinics for is many of their basic primary health care services, contraception, STI testing, cancer screenings, and other basic primary care. That's all that's at issue here.
And so the defund Planned Parenthood Act was to eliminate all Medicaid funding for those basic health care services. That's what this is about. We call them abortion clinics, which is absolutely fine under the California's constitution, but when we say that, we are consciously trying to cover over the basic reproductive health and primary health care that so many Californians women and men depend on. So this is there's a reason why we had to do $90,000,000. There's a reason why we have to move expeditiously with the contract provisions and the others that are in this legislation is because we have a real crisis.
And clinic after clinic after clinic has already had to close in California. But there are so many others that are hanging on by a thread because they are hoping desperately, they know that the governor and the legislature have been committed to preventing that defund Planned Parenthood from devastating their health care. They know we're working on this. So those clinics are just barely hanging on and we have to enact this in order for them to stay viable. So I'm very grateful that the efforts have been undertaken in order to bring us to this point because there are so many of my own constituents that depend on this.
And Senator Small, this is absolutely right. This intentional. Obviously, you cannot have a defund act that specifically names one of the most important providers of health care in this state and not have it be intentional and not have it be a manufactured crisis and a manufactured emergency. So yes, if it was simply a cut to healthcare funding generally, we'd be in a different place. But this is not.
This was an attempt to eliminate these clinics for Californians, and we can't let that happen. And so this is the appropriate response. It's based on the data, but the data is just about women and men who have already shown up for these services, these primary health services, the clinics need their reimbursements in order to continue to operate. So thanks so much for bringing this forward. I'm absolutely committed to supporting this legislation.
And I just I desperately hope we are not here again because Congress decides to one more time go after Planned Parenthood or any other health care provider in the country and certainly here in California. Thanks, Mr. Chair.
Speaker 5
Copy and paste. I mean, was beautifully said. And I know the senator from West Sacramento talked about the other options or the other services that Planned Parenthood provides. And I wanted to add the actual numbers to that. I mean, it's 80 seven thousand cancer screenings in just a year alone.
Over two million STI testing occur and four hundred thousand visits just on contraception alone. And members from the other aisle are talking about where our priorities lie. I mean, wouldn't be in this situation if the federal administration did not decide to put a a bull's eye target, on Planned Parenthood. We'd be able to address all the other priorities that we need to address and not have to focus on this. But we have to focus on this because we know that the health crisis in California is real.
We are struggling in being able to provide all the resources under Med Cal. And it shows that 47% of women under Medi Cal choose Planned Parenthood for their services. That's close to 50% of the people on Medi Cal. And we're already dealing with the big issue with Medi Cal. Imagine how bigger of a hole we'd be in if we did not provide this preventative care that Planned Parenthood provides.
So I don't want to be here. I don't want to be having this conversation. I don't have to want to put aside $90,000,000 for this, but we have to. We have to be responsible. So if we're asking about priorities, I would ask my colleagues on the other side to talk to your counterparts in the federal government and say, Don't put us in this situation again so we don't have to have this conversation.
Speaker 9
Thank you, Chair. I want to thank everyone so much for coming to give us this presentation. Want some clarification, just because of some things that I have heard from different members up here. This funding that are that we will be voting on today is to essentially replace the funding that these particular entities no longer get from the federal government. Is that correct?
Speaker 4
That is correct. And as I said earlier, there was funding in the current year's budget that they're no longer able to access as a result of the freeze due to HR one, and so this is to substitute for that. Okay.
Speaker 9
So this is funding that they would have gotten from the federal government that they are no longer getting. The federal government does not pay for abortion services. Correct? Correct. Correct.
So, as we sit up here and talk about us funding abortion clinics, that's not actually accurate because this money, which they would have gotten from the federal government, was never going to go to pay for abortion services. Correct? That's correct. So, instead, what we're talking about, when we're talking about, you know, why would we give these clinics this money, is because these clinics serve an essential role in our communities, whether we are from a big city or a rural area, a small city, an inner city. And some of my other colleagues talked about that.
You know, we talk about access. We talk about need for more preventative care. When we're talking about the ability for people to go and get their mammograms, their pap smears, their birth control, their STI screening. So that is essentially what this money is funding. Correct?
That's correct. And I would say that I do think that is an essential service. Now, I may be biased because I'm an OBGYN and a woman, but I do think that it is extremely important for people to be able to access preventative care, for them to be able to go. Someone mentioned pregnancy care. Some of these places provide early prenatal care.
Speaker 9
so, these clinics are serving a significant need in our communities for our women, for our families. We are not funding abortion. We are funding the money that this federal government has chosen to take away from our small communities, from our rural areas, that do disproportionately impact women, and unfortunately, women of color, as we see some of these things like breast cancer, cervical cancer, that you can get screening for at these clinics, with this funding that the federal government has removed, disproportionately impacts black and brown women. So, I just want to make it clear, because I was thinking I was in a different hearing, and, you know, since we were talking so much about abortion, this funding is not for abortion care. Federal government does not cover abortion care.
We are replacing the money that the federal government has chosen to remove from these institutions that provide basic, preventative, well women health care for people in all of our districts. Thank you.
Speaker 16
Thank you, Mr. Chair. I certainly appreciate that our good senator, who is an OBGYN, has provided most of the information and comments that I would have wanted to share. There have been a few comments that say the public needs to know. The public needs to know.
Something that I would like to have answered is we already know we're not funding the abortions themselves, but what percentage of the services that you provide are actually abortions?
Speaker 16
The numbers that I have seen are three to four percent. Does that sound reasonably accurate?
Speaker 16
you. And I think that referring to them as abortion clinics, I think minimizes the absolute necessity of the services that are being provided. These are medical clinics. As my colleagues have said, they provide basic health care services, not just to women, but to men also. And I thank you for the services that are provided in our communities.
Thank you.
Speaker 17
Thank you. I appreciate the passion that's brought to this topic by my colleagues. And I just want to add my voice to the support of this and recognize what senator the other good senator from San Diego brought up about the fact that this money is backfilling these really important services, including cancer screenings, contraception, STI testing, mammograms, prenatal care. But it's also really important to recognize that abortion care is health care. And in California, we do support Planned Parenthood, and we do want women to be able to access the whole range of options for them to live free and autonomous and in charge of their own body life.
And so recognizing, I don't see it as a problem that three percent to four percent of what Planned Parenthood does is abortion care. And I don't really care what the percentage is. I see that as part of the health care spectrum that women will seek and have always sought and need in order to have control of their own body and their own destiny and their own life and their own choices. And we shouldn't shy away from recognizing the critically important role that Planned Parenthood provides when they provide that service. And it's important, I think, to also say that the fact that fifty percent of patients are choosing a Planned Parenthood clinic when they're on Medi Cal is because of that supportive environment, because they know they're going to have the range of options, and they want to be able to seek care in an environment that is not going to be judgmental of the different options that they might want to seek.
So, you know, recognizing abortion care as foundational for health care, as something that's part of women's health, as something that California supports when we support women, is just a critical value, and it's important that we say it, and we say it out loud, we recognize it as part of the landscape. And I'm very happy to be here on the budget committee able to support this today.
Speaker 2
Thank you, Mr. Chair. I think it's important to point out without launching into the debate because, frankly, this particular debate can typically not be bridged. But the fact of the matter is underlying this is pro life versus pro choice positions. I think that's fairly obvious.
But a couple of points. First of all, it's pointed out that this is because of HR1 and action taken there. Is it the plan of the administration to come forward with augmentations to the budget for every impact of HR1 that the administration doesn't like?
Speaker 4
I think I noted this at the first hearing that we had here a couple weeks ago, that the state of California is not in a position where we can backfill, but we are in a position where the administration wants to work with legislature on those issues that we share and that we agree on in in regards to priorities and what we can afford to backfill. And, obviously, we are we are facing a difficult budget year. We're structural deficits, and that makes that question even harder, which is why the partnership with the legislature on what those shared priorities are is going to be very important. So to a direct answer to your question is we aren't able to backfill for all those lost federal funds, but we definitely want to have conversations about where we can now and in the near future.
Speaker 2
So it will be within affordability those things that are, from a policy perspective, particularly valuable to the administration?
Speaker 4
We will put forward things that are priorities for the administration, and we expect the legislature will also put forward those that are priorities for them. And, as always, to discuss and come up with what that ultimately looks like in the final budget.
Speaker 2
I'll speak to that. Senator Smallwood Quavis and others have articulated this as an attack, the reduction in funding being an attack. I'd be careful with that. I understand the emotion behind the issue, but I'd be careful with that because a logical conclusion there would be that any negative adjustment in the budget is going to be an attack on whomever that is affected, and we have that very serious structural deficit that we are going to have to address. A quick point with regard to the issue of lack of transparency.
I think that Senator Sciartto raised a very good issue that we're not going to know really where this money goes. And it seems like we're adopting a formal position of lack of transparency. Just today there's a news report about a bill that will specifically shield information on the high speed rail project from public consumption. This is troubling. Two examples of it.
There are others that we could talk about, but I don't want to extend this hearing for things that are adjacent. But that is a troubling thing. It seems to be we're adopting lack of transparency almost as a formal policy. Now, a budget is a statement of priorities. Fundamentally a statement of priorities.
And by this action we're essentially stating that this issue has a higher priority than a few other things. Number one, Proposition 36 funding. There is some in the current budget, but it is wholly inadequate, and there is nothing in the governor's January proposal. And, Senator Cabaldon, rightly talked about the voters spoke with regard to abortion rights, and I agree with that. The voters did spike speak with regard to abortion rights.
I don't agree with it, but they did. The voters also spoke about proposition 36 and public safety in the context of Proposition 36. I do agree with that. The governor clearly does not. So the Planned Parenthood funding is seemingly by choice having a higher priority than the choice of the voters with regard to proposition 36.
And with regard to that issue of abortion funding, good points by senator Weber Pearson except that the dollars that we're talking about are not federal dollars. They're not restricted from funding abortions. They're come the dollars are coming from the state. So what is gonna happen with them? I don't know.
I'm not going to allege that they're all gonna go, to fund abortions, but I am gonna say they certainly can. There's no Hyde Amendment in the state of California. So that's somewhat of a compromised point. This has a higher priority than, as has been pointed out, those with developmental disabilities, particularly with regard to the self determination program, drastically cut back. So these clinics are more important than those folks who are severely severely disabled.
This has a higher priority than the health of job creators in the state of California, our employers. We have a huge debt to the federal government for unemployment insurance that as long as it is unpaid is going to create increasing costs to the employers of the state for every employee that they hire serving to discourage them from hiring those employees. And I would point out, as everybody knows, not news, California is the only state in the country that did not pay the debt that was created by the shutdown of the pandemic. $20,000,000,000. And in the current budget and the proposal for the upcoming budget, a goose egg well describes the amount of money allocated to pay back that debt.
It's a statement of priority of our job creators. The last one I'll talk about is rural hospitals because this one is truly troubling. Christopher Kobolden, our executive Kobolden, said that we have a real crisis with regard to these clinics. I'm not going to debate that point, but that ignores the real crisis that we have with regard to rural hospitals. What proportion of people that take advantage of rural hospital services that still exist are Medi Cal?
You probably don't know the proportion. I'm not going to ask you to give me a proportion, but you have to admit it's high. And it's been said patients Planned Parenthood's clinics serve are Medi Cal patients. We got the same thing and we're not doing anything for rural hospitals. And isn't it interesting that Planned Parenthood provides health care but also abortions, and rural hospitals have labor and delivering wards.
They're delivering babies and they're providing that healthcare and they're closing and the people that live in those areas have no other options unless they drive 50 miles plus. That I would suggest is a crisis. It was also stated I think by Senator Weber Pearson that clinics serve an essential role. I won't debate the point. Rural hospitals serve an essential role.
So we are by voting for this and ignoring that, we are saying that Planned Parenthood's health clinics have a higher priority to us than any of those other things that I mentioned as well as their survival of rural hospitals. That's a problem for me.
Speaker 1
Thanks, Adith. I have one more person on the list and it's Senator D'Arrazo. And then I'm going to make a few comments and we're going to public comment unless there's somebody else that I don't want to encourage it. Senator Perez, you'll follow Senator D'Arrozzo.
Speaker 15
I'll turn my time over to senator Webb Pearson, but I just wanna say I am supporting this budget item because I know that it will save clinics who provide essential family health care services in our communities. I do not wanna see those services closed down. And I, like many of us here, are fighters for health for all and no distinctions. This is a very, very explicit, deliberate way of going after women's services, family planning services, and we should be very clear about that. This is not choosing between health care and distressed hospitals and the other fake proposals that have been stated here.
This is about saving on an emergency basis what has been triggered and caused by the federal administration. Do this can I hand my a minute I had left over?
Speaker 9
Oh, no. I just wanted to say that I think all of us up here are very concerned about all of our hospitals, especially our rural and small hospitals. One of the good things, though, about these clinics is that they help keep people out of hospitals. And we talk about access, and we talk about how expensive health care is. I would rather someone have access to go and get a pap smear than have to manage their cervical cancer.
And I have had those patients, so I just wanted to put that out there.
Speaker 18
Appreciate the conversation today. You know, the one thing that I'll just add, and I'm sure that my colleagues have brought this up, but just because it was mentioned, you know, by Senator Nilo is, you know, because of the Hyde Amendment, federal funds cannot be used for abortion. And I know you just referenced that, but this was clearly an attack on Planned Parenthood's operations overall. And, you know, that means, as Senator Weber Pearson just mentioned, pap smears, STIs, STD testing, all of the other services that Planned Parenthood provides. And as a woman, I know how critical those clinics are.
I have one that is very close to my home that I've certainly gone to before. I know many family and friends who have relied on these places for services. And so, do think it's incredibly important that we do this. And, you know, talking about transparency and everything, I actually think this is very transparent in terms of what we're doing, is continuing to make sure that we're funding women's health services, something that I think we all understand and know is incredibly critical. So, I just want to highlight that, and we'll be strongly supporting this.
You know, I've been meeting with Planned Parenthood and have been discussing with them the financial impacts, especially our local affiliates have been facing, and it's been really devastating. But they have done the hard work to continue to keep their doors open because they know that they provide life saving services to people all over California. But when I read in the news on a regular basis that you have, you know, young women who are dying because they can't get basic access to care in conservative rural areas across the country because of abortion bans or because Planned Parenthood clinics have been closed. Those things are horrifying. Events should not be happening in The United States.
It's incredibly concerning. Urgent I vote. Thank you.
Speaker 1
Thank you very much. That completes my list. I'm going to make a few comments, and then we are going to go testimony. So if you're going to do public testimony, please stand ready. I wanted to inject some facts into the discussion based on some of the questions.
First, we will be having our next hearing on HR one. So when we meet, and I believe it will be the hearing we have next week, we will be examining that and going into depth. So some of the other issues will come up there. This is based on the existing amount of money that goes to these clinics. If the number is $335,000,000, that is what goes without abortions.
So we are funding the level of service without abortions that exists at the existing clinics. From the one I am most familiar with that was in my hometown, this is a broad level of health services. This isn't just reproductive care. It is a broad level of care with people coming in and getting medical treatment. So what we are doing, what the federal government is doing, is they are penalizing clinics that deliver certain services that weren't funded by the federal government by cutting general medical care to thousands of people.
That is what's happening here. And to clarify one thing, because there was a question about ongoing, this was a one time cut in in this budget. It will take an act of congress and a signature of the president to continue it in a second year. And if if things are going and they just approved the continuing resolution or whatever it is on health and human services, it did not include a further cut on this when that was approved. So we are taking ongoing services that are general health services at the level at which they have been funded and filling behind it.
And we're doing that because it was an emergency that was immediately upon signature. These cuts have been in effect for months. And so to compare it to other things we will consider in the budget that have not been cut yet is not an apt comparison. And we will consider all these other things in the budget. As somebody that has spent most of the time in the Senate trying to save a rural hospital, the irony is we saved it and this is the year it was gonna be the first year in the black for six years, and it's going back into the red because of the very federal bill we're talking about that cuts the rates to the hospitals.
And so obviously we're gonna talk about that as we go through the budget, but that cut hasn't taken effect yet. This cut has taken effect now, and it is affecting $335,000,000 of general health care services that did not include abortion. And I think it is very important to to make that clear in what we have in front of us. With that, we will move to public testimony. This is the opportunity for anybody here to address the committee.
Please state your name and your organization, and we will allow comments in general on the budget. But obviously, we hope you're going to testify on what we're hearing. So welcome to the committee.
Speaker 1
And we will formally recognize the motion and take a vote after the public comment. Welcome.
Speaker 19
Thank you. Angela Pontis, on behalf of Planned Parenthood Affiliates of California, in strong support, thank you for hearing this bill today.
Speaker 20
Chair and members, Kathy Mossberg with Essential Access Health. I want to echo the comments of Planned Parenthood. Thank you so much for your continued commitment in this issue area and moving this along so quickly. Look forward to having further discussions in the regular budget process about other areas in reproductive health that we need desperately need funding for, as well. Thank you.
Speaker 19
Good afternoon, Chair members. Whitney Francis with the Western Center on Law and Poverty. We appreciate the legislature's leadership on this issue, and we're in support of this bill to fund family planning providers impacted by targeted federal cuts, as these clinics overwhelmingly serve Medi Cal members by providing essential reproductive health care services.
Speaker 21
Good afternoon. Eric Dowdy on behalf of the California Dental Association. Here in a non AB 106 issue, CDA urges the legislature to reevaluate the cuts to Medi Cal dental. It's about a $362,000,000 cut, a billion dollars when you take into account the federal match. It's overall a third of the Medi Cal dental program.
The reduction is also a rate cut of about 40% to providers. That really cannot be made up. So the critical services that they provide would lead to more emergency room visits. We really don't want to see that in this environment. So we look forward to working with you moving forward through this budget cycle.
Thank you.
Speaker 1
Thank you very much. And just for people that might not have been here when we started, because we didn't have public comment after our first hearing, we did say that if anybody had a comment on something that wasn't this item, they can make it. So welcome to the committee.
Speaker 18
Thank you so much. Angela Hill, California Medical Association. I'd like to thank the committee for your decisive action in the legislature for AB 106. CMA is in support and really applauds your efforts to protect these clinics providing reproductive care. Thank you.
Speaker 6
E. Egwyle, on behalf of CAFP. Just want to express support for AB- Can you
Speaker 6
In support of AB 106, to support our state's critical safety net health care services. Thank you.
Speaker 6
Afternoon, chair and members. Omar Altamy with the California Panethnic Health Network here in support As the federal government has created many funding gaps for a number of programs across the state, it's important for the state to look for ways to backfill some of the ways some of those gaps that exist, like we did today. Thank you.
Speaker 22
Thank you, Mr. Chair. Ryan Spencer, behalf of the American College of OBGYNs District nine. We're in support of AB 106 for the reasons previously stated. Thank you.
Speaker 23
Mr. Chair and members, Erin Evans on behalf of Santa Clara County. Really appreciate the opportunity to make comments. Well, I should say the county very much supports reproductive health care, but I'll also make comments more broadly. As it relates to HR1, the County Of Santa Clara operates the second largest public hospital system in the state.
And we operate two of the three trauma centers and burn centers that serve our whole region. These critical lifesaving services are at risk due to HR1, and so we look forward to partnering with the state in a few different ways to preserve enrollment in these important services, Medi Cal and CalFresh, to provide dedicated state funding for public hospital systems, as well as to allocate new resources to counties who may be needing to serve increased uninsured populations. Thank you. Thank We look you forward very to the next week's hearing.
Speaker 24
Afternoon. My name is Dan Okenfuss. I'm with the California Foundation for Independent Living Centers, and here to express our concerns about proposed budget cuts affecting critical supports for older adults and people with disabilities, namely cuts to IHSS, the reduction of the IHSS residual program, and elimination of the IHSS backup provider system. Thank you so much for this opportunity.
Speaker 25
Good afternoon, mister chair and members. Raymond Contreras on behalf of Habitat for Humanity California, specifically on the Cal Home program. It is the only state program that addresses the supply side of the housing crisis in California for low income, first time homebuyers. Last year, the state budget allocated $0 for Cal Home, which means there will not be another NOFA this year. The program will officially be inoperative, leaving hundreds of units in the pipeline without adequate funding.
It is also important to note that Habitat and their homeowners cannot use the down payment assistance program to build new units. Those programs are reserved for purchase of existing homes with traditional market rate interest mortgages. The state must consider homeownership as part of the continuum of housing when we build new for sale units for low income families. The state can't continue to ignore this program and let it slip through the cracks. Please support the $500,000,000 ask for Cal Home.
Thank you.
Speaker 1
Thank you very much. That completes our public comment. It's back for action. Senator D'Arrazo had earlier made a motion. Unless there's somebody that desperately thinks something has been left unsaid, we will move to a vote.
Then please call the roll, and the motion is due pass on a b one zero six.
Speaker 3
Laird, aye. Nilo? No. Nilo, no. Archeleta?
Aye. Archeleta, aye. Blakespeare? Aye. Blakespeare aye.
Cabaldon? Aye. Cabaldon aye. Choi? No.
Choi, no. Dorado? Aye. Dorado aye. Hurtado aye.
McNerney aye. McNerney aye. Mantjabar? Aye. Mantjabar aye.
Mantjabar Ochoa Bog? No. Ochoa Bogue, no. Perez? Aye.
Perez, I. Reyes? Aye. Reyes, I. Richardson?
Siarto? No. Siarto, no. Smallwood Cuevas?
Speaker 1
That passes. What is the Twelve four. Twelve four. That passes and will be reported out. That completes our business.
Thank everybody, for participating in this hearing. The Senate Committee on Budget and Fiscal Review stands adjourned.
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