April 27, 2015
Area(s) of Interest: Access to Care Advocacy Payor Issues and Reimbursement
California’s policymakers are continuing to show support for legislation that would fully fund the state’s Medicaid (Medi-Cal) program. Two bills would restore a 10 percent reimbursement rate cut and raise those rates to Medicare levels, allowing better access to health care for patients.
Assembly Bill 366 (Bonta, D-Oakland) and Senate Bill 243 (Hernandez, D-West Covina) are currently moving through the legislature. AB 366 took its first step through the legislative process when it advanced to the Assembly Appropriations Committee with unanimous approval on April 14. Last week, it was SB 243’s turn.
SB 243 came before the Senate Health Committee on April 23, where Senator Ed Hernandez described the necessity for passing the bill.
“Expanding access to health coverage as we’ve done under the ACA [Affordable Care Act] is a significant accomplishment,” he said. “But in order to truly be revolutionary, coverage must be accompanied by meaningful access to a provider. Unfortunately, millions of Californians in the Medi-Cal program lack the access because we pay the providers an embarrassingly low rate.”
The amount of money California pays providers for a regular primary care visit under Medi-Cal is just $16, putting the state nearly last in the country for Medicaid reimbursement rates. California also had the second lowest physician participation rate in Medicaid programs. Studies show a direct correlation between the two.
By next year, it is expected that over 12 million Californians — or nearly one-third of the state’s residents — will be enrolled in Medi-Cal, making the current model for reimbursement unsustainable, according to Hernandez.
Senate members in the health committee seemed to agree, voting 8-0 to move the bill to the Senate Appropriations Committee.