January 07, 2014
Area(s) of Interest: Advocacy Health Care Reform
The United States Supreme Court this week denied a California Medical Association (CMA) petition requesting review of an appeals court ruling in CMA's Medi-Cal lawsuit. The suit sought to stop the State of California from implementing a 10 percent Medi-Cal provider rate cut. CMA has been fighting in the courts and in the legislature to stop this law since it was adopted by the state legislature in the spring of 2011. Despite this setback, CMA's fight to stop the cuts will continue. Over the past five years, CMA has fought these cuts in court, preventing the state from slashing California's already dismal Medicaid rates and saving California physicians over $200 million dollars.
Even though the appeals court ruling cleared California to implement the cuts retroactively to 2011, CMA successfully lobbied to prevent the state from trying to recover those funds retroactively. Last week, Governor Jerry Brown announced that the state would not be moving forward with retroactive collection of the cuts, a win for physicians and patients in California. The announcement came as part of the governor's 2014-2015 fiscal year budget proposal.
Federal law requires that Medi-Cal patients have the same access to physicians and other health care providers as the general insured public. Shortly after the legislature passed the 10 percent cut in the spring of 2011, CMA filed a lawsuit seeking to stop the state from balancing its budget on the back of its most vulnerable citizens. Shortly thereafter, a district court enjoined the cuts, finding that they would irreparably harm the millions of patients who rely on Medi-Cal for health care.
In January 2013, a three judge panel of the Ninth Circuit Court of Appeals ruled that the state could move forward with the rate cuts. CMA and the other plaintiffs in the case requested a rehearing from the full Ninth Circuit Court of Appeals, which was denied. CMA then asked the U.S. Supreme Court to review the appeals court ruling, but the Court yesterday declined CMA's petition.
CMA is part of an unprecedented coalition of physicians, dentists, health care workers and hospitals that will continue working to stop the cuts. The coalition, called “We Care for California," includes the largest statewide organizations representing physicians, dentists, hospitals and health care workers, as well as health plans, first responders, caregivers and other health providers. CMA and the We Care for California coalition will continue to push for full restoration of the cuts moving forward.
Under the Affordable Care Act, more than 3 million patients are expected to enter Medi-Cal over the course of the next two years. “As the rest of the nation looks to California for an example of health reform success, we simply cannot move forward with a 10 percent prospective cut to the Medi-Cal program while simultaneously adding new patients to the program," says CMA President Richard Thorp, M.D. “CMA and our stakeholder partners will look toward reforms that will result in real access to care so that health reform is more than an empty promise of an insurance card."
Even before the cuts, California's Medi-Cal provider payment rates were the lowest in the nation. Low reimbursement rates have forced many of California’s providers to stop seeing Medi-Cal patients. As a result, 56 percent of Medi-Cal patients report difficulty finding a doctor. If these cuts are not stopped, Medi-Cal will become nothing more than a broken promise of access to care.