The latest budget plan from California Governor Arnold Schwarzenegger would force 200,000 children off low-cost medical insurance, end in-home care for 350,000 infirm and elderly citizens and slash income assistance to hundreds of thousands more.

And that's the best-case scenario under Schwarzenegger's prescription for filling the state's $19.9 billion deficit.

Refusing to consider broad tax hikes, he is relying mostly on $8.5 billion in reduced expenditures including drastic cuts to health and social spending that has long made California one of the leading U.S. states in providing help to the needy.

Schwarzenegger also is counting on the U.S. government contributing nearly $7 billion that he says is due California because of various federal mandates.

If federal money fails to materialize, the governor's plan would trigger deeper cuts that would dismantle entire programs, including the state's welfare-to-work system, CalWorks.

Enactment of the Republican governor's proposal, with or without Washington's cooperation, is far from certain given that leaders of the Democratic-controlled state legislature immediately rebuffed it as too harsh.

Even representatives of Schwarzenegger's own government acknowledged the drastic scope of his proposed cuts, which the governor himself described as "draconian."

"They are major reductions in health and human services in California, whether we get the federal funds or not," said Amy Palmer, spokeswoman for the state agency overseeing many of the programs hardest hit. "If we don't get the federal funds, the reductions ... are devastating."

Critics say many such cuts ultimately would cost the state more money than they save, as when elderly patients forced out of adult day-care facilities end up in nursing homes.

[...]

Without extra federal money, CalWorks would be eliminated altogether, leaving California the only U.S. state no longer a part of transforming the nation's welfare system into a program aimed at moving poor, jobless Americans into full employment.

Others programs on the chopping block include transitional housing for foster youth; low-cost Healthy Families medical insurance for needy children, the Medi-Cal healthcare plan for the poor, and a network of subsidized in-home care for the elderly and disabled.

At least 200,000 children are slated to lose eligibility for Healthy Families, with that number growing to 900,000 if the program is gutted entirely.

Nearly 90 percent of the 400,000 recipients of In-Home Support Services stand to lose care under Schwarzenegger's best-case scenario, and state reimbursements to providers of those who remain would be slashed to minimum-wage levels. Otherwise, the program would be abolished, throwing 350,000 caregivers out of work.

For Medi-Cal, Schwarzenegger has proposed clamping new limits on health services while raising premiums and patient co-pays if he gets the extra federal money he wants. Medi-Cal for legal immigrants in the country less than five years would be eliminated, unless they were pregnant.

If additional federal funds fail to arrive, some 450,000 Medi-Cal recipients would be stripped of eligibility and most optional adult benefits, such as reimbursements for hearing aids and other medical equipment, would be scrapped.