The perennially contentious relationship between the state and county governments over money has a new flash point -- the expansion of Medi-Cal coverage to more than a million low-income Californians under the new Affordable Care Act.
The conflict -- aired Wednesday in an Assembly budget subcommittee hearing -- has two prongs:
Whether the state or counties will manage the expansion.
Whether the state should "claw back" some of the money it now pays to counties to pay for indigent medical care -- on the theory that many of the half-million poor beneficiaries will become Medi-Cal patients next year, raising state costs.
Gov. Jerry Brown's administration is still undecided whether to opt for county or state management, but the larger counties have said they don't want it, the Legislature's own budget analyst recommends state management, and the major pending implementation bill also opts for state operation.