Brown Signs Budget; Advocates Criticize Medi-Cal Provisions
On Friday, Gov. Jerry Brown (D) signed into law a budget plan that includes hundreds of billions of dollars to expand Medi-Cal but maintains a 10% reimbursement cut for providers participating in the program, AP/Modern Healthcare reports. Medi-Cal is California's Medicaid program.
Advocates say the provisions could hinder access to care for Medi-Cal beneficiaries (AP/Modern Healthcare, 6/21).
On June 15, California lawmakers approved a $156.4 billion state budget plan that included several provisions that affect the state Department of Health Care Services, the Department of Public Health and other health care-related agencies. The plan was about $1.2 billion more than proposed by Brown.
The proposed budget was approved by a 25-11 vote in the state Senate, with one Republican lawmaker voting in favor of the proposal, and by a 55-24 vote along party lines in the Assembly (California Healthline, 6/16).
The budget signing last week was "one of the earliest and rancor-free in recent history," according to the Sacramento Bee (Siders, Sacramento Bee, 6/20).
Details of Medi-Cal Provisions
The budget plan includes $438 million to expand Medi-Cal under the Affordable Care Act.
However, lawmakers kept in place a 10% cut to Medi-Cal reimbursements (California Healthline, 6/16). According to AP/Modern Healthcare, the state will save $272 million by keeping the rate reduction in place.
State finance officials said the budget includes provisions that will end the payment cuts if they are found to impede beneficiaries' access to care.
Concerns About Medi-Cal Access
Health care advocates say the Medi-Cal provisions included in the budget are contradictory and could hinder beneficiaries' access to care.
Medi-Cal reimbursement rates are among the lowest Medicaid payment rates in the country, and the cuts could cause doctors to stop treating Medi-Cal patients because their overhead costs outstrip reimbursements, AP/Modern Healthcare reports.
According to the California HealthCare Foundation, just 57% of primary care physicians currently accept new patients who are covered by Medi-Cal, compared with 76% who accept new patients with private insurance. CHCF publishes California Healthline.
The number of fee-for-service providers participating in the program also is on the decline, dropping from about 109,000 enrolled physicians in spring 2013 to about 82,600 enrolled as of May, according to DHCS. However, DHCS spokesperson Norman Williams said those numbers are misleading because they do not include providers who participate in Medi-Cal managed care plans.
California Medical Association President Richard Thorp said Medi-Cal beneficiaries "might have an insurance card and not be able to get into a doctor's office anywhere."
Ted Mazer, an executive committee member of CMA, added that "access to Medi-Cal is far below what anybody would call reasonable."
Meanwhile, Eileen Espejo with Children Now called the budget's Medi-Cal provisions "a contradiction" because the plan adds 1.9 million residents to the program while cutting reimbursements for providers (AP/Modern Healthcare, 6/21).
On Friday, Capital Public Radio's "KXJZ News" reported on Brown signing the budget plan (Orr, "KXJZ News," Capital Public Radio, 6/20).