California Budget Proposal Raises Questions Of Vaccine Bill Retaliation

Assembly Republicans want to know if Legislative Democrats are using their state budget proposals to punish a medical group that opposes California's controversial vaccine bill.

In separate proposals for the fiscal year that starts in July, Senate and Assembly Budget subcommittees voted last week to restore six of the seven optional Medi-Cal benefits that are currently unfunded by the state. There's only one benefit they're not proposing to restore: chiropractic services.

The California Chiropractic Association has come under fire for its involvement in the vaccine bill debate. The measure's supporters accuse the Association's president of encouraging opponents to harass the bill's author and lead lobbyist. The California Chiropractic Association strongly refutes that charge and says the California Medical Association, which represents doctors, is trying to bully chiropractors out of the legislative process.

In a letter late Tuesday to Assembly Budget Chair Shirley Weber (D-San Diego), Asm. Shannon Grove (R-Bakersfield) asks why chiropractors were left out of the optional Medi-Cal benefit restoration proposal.

"As an opponent to SB 277 (Pan/Allen), I am hopeful that the opposition of chiropractors to the bill was not part of the rationale for excluding chiropractors from Med-Cal provider rate proposal," Grove writes in the letter prepared by the office of Assembly Minority Leader Kristin Olsen (R-Modesto).

Budget subcommittees approved the proposal last Thursday by votes of 4-0 in the Assembly and 3-0 in the Senate. Asm. Grove and Sen. Jeff Stone (R-Temecula) joined Democrats on each panel in voting yes; a second Assembly Republican was absent. Grove told Capital Public Radio she would have voted no had she been aware of the exclusion.

The full Senate Budget Committee approved the recommendation on Friday. The Assembly Budget Committee approved it this morning, after Democrats told Asm. Brian Jones (R-Santee) that the omission had no connection to the vaccine bill.

The California Chiropractic Association says it does not yet see any evidence that it’s been intentionally excluded by state lawmakers as punishment for its vaccine bill opposition. "If it is true as Assemblywoman Grove suggests, that this decision was made based on CCA'S opposition to a single bill, it is a sad day in California when [the California Medical Association] works to limit access to healthcare," CCA President Brian Stenzler said in a statement.

The Assembly Budget Committee says it received letters asking for the restoration of each of the optional benefits except chiropractic services.

Democrats who supported the proposal told Capital Public Radio they made no connection between the Chiropractic Association's opposition to the vaccine bill and leaving chiropractic services out of their budget proposal.

"There was just no correlation in my mind between actions of the chiropractors in another highly controversial bill and the actions we took in the budget committee," says Sen. Holly Mitchell (D-Los Angeles), who chairs the Senate Budget Subcommittee on Health and Human Services.

"I can tell you that without a doubt, our adding of those optional benefits had nothing to do with any connection to the issue of immunization," says Asm. Tony Thurmond (D-Richmond), who chairs the Assembly Budget Subcommittee on Health and Human Services. "And until you mentioned it, it never dawned on me that there could be any connection."

Asked if he knew of any legitimate policy reason to exclude only chiropractic services, Thurmond replied: "I really can’t think of a single one."

Assembly Subcommittee

The six optional Medi-Cal benefits proposed for restoration are: Acupuncture, Audiology, Incontinence Creams/Washes, Optician/Optical Lab, Podiatry and Speech Therapy. The total cost to the state's general fund of restoring the six benefits is $15 million. Gov. Jerry Brown's Department of Finance says it would cost the general fund an additional $257,000 to restore chiropractic services as well.

Senate Subcommittee

Mitchell says there is a legitimate policy reason to leave out chiropractic care: It's not considered an "essential health benefit" under the Affordable Care Act, and it's not part of the standard "benchmark" plan under California's Health Benefit Exchange, Covered California.

But Senate staff acknowledged that only some of the other six optional benefits fall into that category, and the Senate Budget Committee chose to prioritize which services to restore.

Note: This story was updated at 12:30pm Wednesday to reflect the Assembly Budget Committee's action.