Pressure Rising to Restore Medi-Cal Provider Rates

By David Gorn, California Healthline

A protest Wednesday at the Capitol Building will highlight proposed legislation to reverse cuts to Medi-Cal provider rates.

In 2011 during a bleak budgeting period, the Legislature agreed to cut most Medi-Cal provider payments by 10 percent. The cutbacks were held up in legal battles for two years, and the court eventually sided with the state. Implementation came from the state in stages, and primary care providers started getting the lower reimbursement rate this year, on Jan. 1.

Last month, Assembly member Rob Bonta (D-Alameda), who chairs the Assembly Committee on Health, introduced a bill -- AB366 -- to reverse the cuts made in 2011.

"This is my top priority," Bonta said. "The reason I'm interested in health policy is to maximize quality care and access for as many people as possible. And access within Medi-Cal is not what it needs to be."

The number of providers participating in Medi-Cal has dropped, Bonta said, because they lose money on Medi-Cal patients and can't afford to take on too many of them.

Legislation to restore Medi-Cal rates has been floated before and failed. Bonta said those efforts were setting the groundwork for this push.

"The urgency is at a level it's never been at before, with one-third of the state in Medi-Cal, with 12 million folks on the program," Bonta said. "We think some of the buildup has put us in a good place. There are huge moral and policy reasons for this."

That's what the people gathering on the Capitol Building steps will try to convey. The event is co-sponsored by the Service Employees International Union-United Healthcare Workers, which is pushing for eventually setting reimbursement levels at Medicare rates, though Bonta's bill doesn't include that stipulation.

The big test for the bill will be the receptivity of Brown administration officials, who have made it clear they believe the state pays a steep price for Medi-Cal already, and that cost will rise when the federal government gradually steps down its funding of beneficiaries from Medi-Cal expansion.

"This issue is moving on two tracks, the bill and the budget talks," Bonta said. "For us to hit the governor's needs in the budget, we need to push hard and say we need this, that this is one of the things we need."