Health and Human Services Secretary Kathleen Sebelius on Sunday threw cold water on Gov. Jerry Brown's plan to ask California's poor to contribute to their federally subsidized healthcare — payments the governor has proposed to save the state more than $500 million a year.
Brown met with Sebelius for 45 minutes in Washington, where he renewed his pitch for more flexibility in how the state handles Medi-Cal, its health-insurance program for the poor. The governor wants co-pays from recipients for emergency-room visits as well as routine trips to the doctor and dentist, beginning in October.
"Everybody has to have some skin in the game," Brown said of his co-pay plan. "For some people, they're so destitute that's impossible. OK, I understand that. But … I think there's a wiser path than the one we're on."
The Obama administration turned down a similar request earlier this month. On Sunday, Brown said, Sebelius told him that there were legal obstacles to his proposal but hinted that there were other ways the state may be able to save money in its Medi-Cal program, which helps more than 7 million Californians. Brown said the secretary did not specify what those ways might be.
Sebelius' office did not respond to requests for comment.
Brown has been in Washington for the National Governors Assn. winter meeting, and he was not the only state leader to request federal waivers. As Brown met with Sebelius, Illinois Gov. Pat Quinn stood outside awaiting an audience.
Like California, Illinois has been denied requests for leeway in administering healthcare for the poor. Quinn said he was about to brief the administration on his Medicaid plan, which serves about 2.7 million people, and acknowledged that Illinois is considering a co-pay similar to the one introduced by Brown.
"We anticipate there will be a series of state amendments" requiring federal approval, Quinn said.
Brown finished his day at a black-tie White House dinner hosted by President Obama and First Lady Michelle Obama. He had begun it with an appearance on NBC's "Meet the Press," where he made a pitch for Obama's reelection and derided the Republican presidential field as a collection of "unreasonable men."
With rising gas prices becoming an issue in the presidential campaign, Brown praised Obama's call for higher fuel-efficiency standards for cars and trucks. He also reiterated his call for changes in immigration policy.
"You can't round up 12 million people and ship them across the border. That's a disaster," Brown said. "We need comprehensive immigration reform with a path to citizenship."
On his way out, Brown was handed a transcript of an appearance he made on the show in 1975, during his first term as California's governor. In a brief discussion with reporters after the taping, he smiled as he read aloud the first question he received that day, about comparisons that had been made of him to Ronald Reagan and former Alabama Gov. George Wallace. All of them had criticized government spending.
Brown recited the answer he gave then, when asked if the comparisons were valid.
"I said, 'It's as valid as any other journalistic metaphor,' " he said with a smile.
Brown will be back at the White House on Monday, joining other governors in a session with the president and meeting with White House Senior Advisor Valerie Jarrett, his staff said.