June 05, 2013
Area(s) of Interest: Access to Care Advocacy Physician Leadership
In the largest health care rally ever held at the California State Capitol, an unprecedented coalition of physicians, nurses and other health care providers, as well as hospitals, insurers and Medi-Cal patients — approximately 8,000 strong — flocked to Sacramento on Tuesday to protest the 10 percent cuts to the Medi-Cal program set to take effect on July 1.
The “We are Medi-Cal” rally was sponsored by “We Care California” coalition, which chartered more than 100 busses from across the state to bring thousands of advocates to the Capitol for the rally and to meet with their legislators and urge them to stop the cuts.
With a little over 10 days left for the legislature to solidify the California budget, the rally sent an important message to the legislature: Every Californian will suffer if the $1 billion in health care cuts are allowed to take effect.
Master of ceremony for the afternoon speeches, Paul R. Phinney, M.D., president of the California Medical Association (CMA) and pediatrician at Kaiser Permanente in Sacramento, pumped his fist and asked the crowd “Are you with us?” The crowd roared back: “Yes!”
Dr. Phinney invited California legislators to the podium to sign a pledge to support legislation to reverse the Medi-Cal cuts. The legislators were led by Chair of the Assembly Health Committee and CMA member, Richard Pan, M.D. Dozens of legislators joined Dr. Pan on the podium and then in a show of support, lined up to sign a poster with their names as a commitment to vote to prevent the cuts.
Dr. Pan likened the cuts to ‘Scrooge taking away Tiny Tim’s crutches.’ "We've all been making do with these low Medi-Cal rates and now the state wants to take back what it has already paid us," he said, referring to retroactive payments the state expects for the past two years' worth of 10 percent cuts that have not been collected while the issue was argued in court.
The United States Ninth Circuit Court of Appeals last month denied a request for an en banc review in the case of CMA et al. v. Douglas, filed by CMA in 2011 to stop the state from implementing the 10 percent cut included in the 2011-2012 state budget. This most recent action cleared the way for the state to implement the cuts.
Despite the state's improved budget outlook, the Governor’s budget includes roughly $1 billion per year in Medi-Cal provider rate cuts. If the state moves forward with these cuts, access to care will be devastated, not only for existing Medi-Cal patients, but also and the millions of patients that will be newly eligible for Medi-Cal under the Affordable Care Act in 2014.
CMA is currently co-sponsoring two bills, SB 640 (Lara) and AB 900 (Alejo), to stop the cuts.
Watsonville legislator, Luis Alejo, author of AB 900, told the crowd his bill would keep California's health care "safety net" in place. "These are our parents, our dads and mothers, our grandparents, people who gave so much their whole lives, and now they need the most critical care," he said.
Speaking before a large group of doctors assembled on the platform, Ruth Haskins, M.D., CMA trustee and OB-GYN with a solo practice in Folsom, said she will have to cut back the number of Medi-Cal patients she sees if the cuts go through.
Dr. Haskins sees 18 to 20 pregnant women in her practice at any one time. Current reimbursement rates are so low, she said, that it means no more than five of those can be Medi-Cal patients, a figure that would drop to three or four under the proposed cuts.
Her office already turns away at least two Medi-Cal patients each day. "I can only take so many, and then I gotta say, sorry, I gotta keep my lights on," Dr. Haskins said.
Modesto Assemblyman Adam Gray spoke to the crowd about access to physicians like Dr. Haskins, who may not be available to continue seeing Medi-Cal covered patients if they cannot cover their costs. “Care isn’t just about being covered, but about having access to the very doctors, hospitals, and clinics that can provide that care. And there is no more important policy worth standing up for than Medi-Cal.”
Increasingly, Medi-Cal has become a broken promise for access to health care. Despite the comprehensive benefits package written into law, the reality is that Medi-Cal patients are often unable to find a health care provider. Low reimbursement rates have driven many of California’s physicians from the program, with current rates already ranking lowest among all states.
The “We Care for California” Coalition – formed this year to expand access to quality health care for all Californians and to oppose further rate cuts to Medi-Cal. It is the state’s largest coalition of health care providers, including major statewide organizations representing physicians, dentists, hospitals, community clinics, first responders, health workers, caregivers, and major health plans.
So often in the past, health care advocates have been divided in their efforts, so focused on individual organizational interests that collective strength was weakened. “We Care for California” intends to stand undivided, using its collective influence in defense of health care. For more information about the coalition, visit www.wecareforca.org.
CMA is urging all physicians to contact their legislators and urge them to stop the cuts immediately. It is critical that the Legislature and Governor Brown understand how harmful these cuts would be for California’s poorest and most vulnerable patients. Call CMA's grassroots hotline at (877) 362-8455 to be connected with your legislator.