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June 12, 2014
Viewpoints: To ensure Medi-Cal patient care, restore doctor reimbursements

RCB_20110915_MEDI-CAL_0089.JPG(June 12 - By Paul Phinney, Special to The Bee)

As budget negotiations come to a close this week, the Legislature and Gov. Jerry Brown are faced with a decision to fund California's Medicaid program - or let millions of people become insured without actually having access to care. As health care providers who see some of the poorest and neediest patients, our hope is that they choose the high road and allocate the $250million needed to restore a 10 percent cut in reimbursements to doctors.

Legislators have long expressed their desire for health reform to succeed in California and have wholeheartedly supported the concept of expanding care to the state's poorest and neediest patients. We join them in that support. It's unfortunate, though, that elected officials are considering approving a budget that doesn't include proper funding for the backbone on which health reform is being built on in this state, Medi-Cal.

In 2011, tough choices were made as the state faced dire fiscal times and across-the-board cuts were made. Assembly Bill 97, passed by the Legislature and signed by Brown, included a 10 percent cut to Medi-Cal reimbursements to physicians - a move that put weight on the shoulders of patients that need care the most.

The good news is that California isn't facing those same dire fiscal times. Now, it's up to the Legislature and Brown to restore funding to Medi-Cal.

For years before AB 97 cuts were approved, California saw a decline in physicians seeing Medi-Cal patients. Under the cuts, provider reimbursement rates are roughly $18 to $24 for a primary care visit. Nationwide, that puts California on the bottom of the list of Medicaid reimbursements.

A 2010 report from the California Health Care Foundation and the University of California, San Francisco, found that in 2008, 90 percent of California physicians were accepting new privately insured patients and 73 percent were taking new Medicare patients. Only 57 percent reported accepting new Medi-Cal patients. Only about one-fourth of doctors were providing care to 80 percent of Medi-Cal patients, the study found. Those numbers are before the 10percent cut, which is likely to further reduce the number of providers able to accept new patients.

Yet we have millions of new patients to take care of in coming months because of health care reform. Brown included $1.2billion in his revised budget to cover the costs of 1.4 million more Californians enrolling in Medi-Cal than earlier projected - a total of about 30 percent of the state's population.

Last year, the We Care for California coalition - representing the largest statewide organizations of physicians, dentists, hospitals, health care workers, health plans, community clinics, emergency responders and patient advocacy groups - came together in Sacramento for the biggest health care rally in the Capitol's history. More than 8,000 patients, providers and advocates joined to urge lawmakers to reverse the cuts.

Now, lawmakers have the chance to ensure that access is a reality and not just an empty promise of an insurance card. Regardless of what happens before the budget deadline, lawmakers should make it a priority to restore funding to Medi-Cal.

Paul Phinney, a Sacramento-area physician, is immediate past president of the California Medical Association.