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We Care for California introduces legislation to increase Medi-Cal rates to Medicare levels



March 06, 2015
Area(s) of Interest: Access to Care Advocacy 

Senate Health Committee Chair Ed Hernandez and Assembly Health Committee Chair Rob Bonta joined health care providers, medical students, patients and advocates on the steps of the Capitol on Wednesday to introduce AB 366 and SB 243, legislation that would not only restore a 10 percent cut to Medi-Cal reimbursement rates, but would also place reimbursement on par with Medicare, increasing payments rates for inpatient hospital services and most outpatient services. The proposals would also require the Department of Health Care Services to pay Medi-Cal managed care plans at the upper end of the rate range so as to ensure a more robust Medi-Cal provider network.


“A Medi-Cal card needs to be more than an empty promise,” said Senator Hernandez. “Expanding access to health care coverage, as we have done under the Affordable Care Act (ACA), is a significant accomplishment. Unfortunately, millions of Californians in the Medi-Cal program lack that access because we pay providers an embarrassingly low rate.”


In 2011, Medi-Cal payment rates to doctors, hospitals, dentists and other providers were cut by 10 percent as a way to balance the state’s budget. California now has one of the lowest payment rates in the country. At the same time, the Medi-Cal program now covers more than 12 million patients, one in three Californians, as a result of expanded eligibility under the ACA.


“I believed then, and I believe now, that health care should be a right and not a privilege,” said Assemblymember Bonta. “Bills AB 366 and SB 243 are critical steps toward ensuring that the health care coverage millions have signed up for is meaningful and actually provides real access to quality health care.”


“As physicians, we want to provide care to patients, and especially to the poorest and most vulnerable among us,” said Luther Cobb, M.D., California Medical Association president. “With primary care reimbursement rates as low as they are, many physicians are forced to stop taking new Medi-Cal patients as they simply can’t keep their doors open. In areas like rural, northern California where I practice, that can mean patients have longer wait times or have to drive farther to get care.”


A 2011 survey funded by the California HealthCare Foundation of over 1,500 Medi-Cal beneficiaries identified difficulties in finding coverage, with 34 percent of Medi-Cal beneficiaries saying it was difficult to find health care providers who accept their insurance, compared to 13 percent of people with other coverage. The survey found a higher percentage of adults with Medi-Cal say they have more difficulty getting appointments with specialists and primary care providers than adults with other health coverage (42 percent vs. 24 percent for specialists, and 26 percent vs. 15 percent for primary care providers).

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