Monday, May 22, 2023







        Settled in for his second and last term in Sacramento, not needing to worry about reelection and possibly looking to establish himself as America’s leading progressive long before a potential future run for president.


 That’s  Gov. Gavin Newsom, who lately does not hesitate to push on many fronts for the priorities he vocally espoused back in 2018 during his first run for governor.


        There was his call for reviving much of the state mental health program and infrastructure dismantled for financial reasons in the 1960s and ‘70s by Govs. Ronald Reagan and Jerry Brown.


        There’s his sometimes heavy-handed push to force every city in California to add great numbers of housing units in an effort to solve the state’s affordable housing shortage, which may not be as extensive as he says, but nevertheless remains very real for millions.


        There’s his push to electrify new cars and trucks and railroad engines. And more.


        But the most revolutionary of Newsom’s causes may be his push to have Medi-Cal (California’s version of Medicaid) not merely ensure health care for every person in this state, regardless of their immigration status, but now to use Medicaid money toward solving the seemingly intractable problem of homelessness.


        Newsom says he’s discussed this with President Biden, who would have to approve it for this to happen. He wants to class lack of housing as a cause of illness and treat homelessness with preventive care, much as most preventive care is covered for pregnant women. Poor women getting this coverage may not be ill when they receive services, but Medi-Cal nevertheless gives them

 prenatal care, labor and delivery coverage, post-partum care for a year after pregnancy, plus all other medically necessary dental and mental health treatments during that time.


        The principle is that such wide care prevents all manner of illnesses for both mothers and newborns, thus saving many millions of dollars in the long term.


        Newsom can’t do this on his own, needing both legislative and federal government approval, but he seeks a new program called “transitional rent” to provide six months rent or temporary housing for low-income persons already enrolled in Medi-Cal who are either unhoused or in danger of losing their housing.


        There are doubts even among liberal Democrats about whether this goes too far. After all, Medi-Cal already covers almost all California’s poor, including every person over 50 in the state who qualifies financially, and some who are younger if they are pregnant or have some other medical conditions.


        Immigration or citizenship status doesn’t matter here.


        If Medi-Cal began covering all or part of the rent for unhoused individuals, it presumably also would cover many of the undocumented to the same degree.


        That’s a novel concept, but this has rarely bothered liberal California politicians who have already granted to the undocumented things like drivers licenses and the right to vote in some local elections.


        For sure, living in homeless encampments, whether in tents, cardboard boxes or with no shelter at all, can lead to illness and death. The Kaiser Permanente health plan’s news service the other day cited a 60-year-old man who needed open heart surgery and repeated emergency room visits for ailments like diabetes and asthma while homeless. He was able to give up some diabetes medications and became significantly healthier after receiving a federal housing voucher that gave him permanent indoor quarters.


        Medi-Cal also reports that 5 percent of its patients account for 44 percent of the program’s spending, a high portion of them with unstable housing, or none at all.


        Does the idea of calling homelessness a threat to health and then acting to mitigate it stand a chance of approval? Pilot programs like this already exist in Oregon and Arizona, so why not approve something similar in California?


        “Why do we have to wait (until) people become sick?” asks Dr. Mark Ghaly, California’s health secretary. “What we have today doesn’t work.”


        He’s right about that, but no one yet knows whether such reasoning will convince Medicaid’s top officials, who would need to approve and will take their cues from Biden.    



    Email Thomas Elias at His book, "The Burzynski Breakthrough: The Most Promising Cancer Treatment and the Government’s Campaign to Squelch It," is now available in a soft cover fourth edition. For more Elias columns, visit

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