As lawmakers reconvene, not everyone agrees on COVID-only agenda

California lawmakers return to the Capitol this week to begin what they describe as necessary but painful negotiations to keep the state running and redirect dwindling funds to the costly coronavirus pandemic.

Leaders of the state Senate and Assembly have asked them to pursue only COVID-related or "essential" bills.

But many legislators say they aren't letting go of their pre-COVID agendas. They're pushing ahead with measures to tax soda, ban flavored tobacco products, reform mental health care and expand public insurance to undocumented immigrants age 65 and up, arguing that the virus's devastating reach underscores just how badly California needs to bolster its public health system.

"This pandemic has highlighted all the gaps, all the disparities in our California health care system," state Sen. Maria Elena Durazo (D-Los Angeles) said at a recent virtual town hall meeting with health care advocates. Durazo is the author of one of the bills to expand California's Medicaid program to older unauthorized immigrants.

After enjoying years of healthy budget surpluses, California is facing the prospect of a major shortfall — reflecting the double whammy of the unprecedented economic shutdown and the pouring of public funds into the pandemic response. It's unclear exactly how large a shortfall, partly because the state gave taxpayers until July 15 to file their income taxes. One estimate by Legislative Analyst Gabriel Petek puts the deficit at $35 billion for the 2020-21 fiscal year.

That's a stark contrast to the $5.6 billion budget surplus Democratic Gov. Gavin Newsom had projected at the beginning of the year, when he touted proposals to address chronic homelessness, reduce prescription drug prices and increase investments in mental health treatment.

Those plans and other work at the Capitol came to an abrupt halt in March when the coronavirus forced the legislature to shut down unexpectedly.

During the recess, Senate President Pro Tem Toni Atkins urged lawmakers in a memo to "put on pause" existing bills and take up only "the most pressing issues."

"I have asked Senators to reconsider their priorities and reduce the number of bills they carry," the San Diego Democrat wrote.

Assembly Speaker Anthony Rendon, a Democrat from Lakewood, asked lawmakers in his house to focus on "essential" bills this year, said Katie Talbot, his spokesperson.

For bills that carry a price tag, Assembly Budget Committee Chair Phil Ting (D-San Francisco) wrote in a memo, "we will no longer be able to consider new priorities and ideas from stakeholders, advocates and Members, with the exception of COVID-19 related costs, wildfire prevention, and homelessness funding."

The Assembly reconvenes Monday and the Senate on May 11.

The governor will release his revised 2020-21 state budget proposal on May 14. After that, the legislature has about a month to hammer out a final spending deal with Newsom's administration.

Unlike in previous recessions, the administration and lawmakers are talking about health care spending bumps rather than cuts because of the nature of the COVID-19 crisis.

"When we had the fires, the voices of emergency folks were prominent in the budget discussions," said Leonor Ehling, executive director of the Center for California Studies at California State University-Sacramento, who spent 20 years working in the legislature. "Now what public health officials say about spending will have added weight."

At a budget hearing in late April, a top state Department of Finance official told lawmakers that investments in health "are certainly at the top of our list."

"We're trying to figure out how to put out a revised budget that will have cuts, but making sure that we reduce the impact and minimize it on the most vulnerable people," said Vivek Viswanathan, the department's chief deputy director for budget.

But what falls under the umbrella of "COVID-related" appears to be broad and subjective. And even advocates for certain issues aren't always on the same side about whether to wait until next year or move forward.

In special budget hearings over the past three weeks, lawmakers agreed the state must secure more masks and other protective gear — not just for front-line hospital workers but also for dentists, primary care doctors, grocery store workers and others who will be instrumental in reopening the economy.

They want California to increase diagnostic testing for COVID-19, deploy thousands of contract tracers to track down and monitor people exposed to COVID-19 patients, and ensure there are safe quarantine locations for infected people. Lawmakers from rural areas want the state to help pay for their coronavirus costs, noting that federal funding went largely to urban regions.

Other lawmakers are seeking hazard pay for some nursing home workers, stipends for nursing students, exemptions for hospitals from state seismic standards and more residency slots for medical students.

"Hospitals are losing money. … Primary care doctors are dropping their visits," said Sen. Richard Pan (D-Sacramento), himself a pediatrician. "A lot of people are in a world of hurt right now."

But some lawmakers say they intend to advocate for issues that aren't directly related to the crisis, issues that in some cases have been debated in the legislature for years.

Assembly member Richard Bloom (D-Santa Monica) intends to push for a soda tax, although lawmakers have rejected soda taxes several times. Under the measure, proceeds from the tax would fund community health programs.

Sen. Jerry Hill (D-San Mateo) wants to ban retail sales of flavored tobacco products, which are popular with young people. He hopes his bill will resonate with his colleagues, noting the World Health Organization has linked smoking to COVID-19.

"They've sounded the alarm that persons, if they use tobacco, if they smoke, if they vape, they're at risk of suffering the worst and most deadly symptoms of COVID-19," Hill said. "To me, that's significantly important in moving this legislation forward."

Durazo, who is carrying one of the measures to expand Medicaid to older unauthorized immigrants, insists the legislature must act quickly. She is framing it as the humane thing to do, and necessary to help stem the spread of the COVID-19 virus.

California already offers full Medicaid benefits to income-eligible residents up to age 26, regardless of their immigration status. Newsom has yet to say whether he will support spending $80.5 million in the next fiscal year to expand the program — a price tag that worries even some supporters of the idea.

"I am concerned about how our economy is going to come out of this pandemic," said Assembly member Joaquin Arambula (D-Fresno).

Ting, a key voice in health care funding, echoed that sentiment. He said some lawmakers are just going to have to adjust to the financial realities of the pandemic.

"We know there is no sector of the state left untouched by this pandemic," he said. "Our biggest challenge, unlike the federal government, is that we cannot deficit-spend. It limits our ability to do all the help that everyone is asking us to do."

This KHN story first published on California Healthline, a service of the California Health Care Foundation.