Governor's January budget proposal leaves state's woeful Medi-Cal reimbursement rates untouched

January 12, 2015
Area(s) of Interest: Access to Care Advocacy 

Gov. Jerry Brown on Friday unveiled a $164.7 billion budget proposal for the 2015-2016 fiscal year. Unfortunately, the budget proposal contains no increases to Medi-Cal provider reimbursement rates.

According to the administration’s estimates, enrollment in Medi-Cal is expected to reach 12.2 million enrollees this year, representing about 32 percent of the state’s population. This is dramatic increase, up from 7.9 million enrollees in 2013.

"While the physicians of California applaud the extension of the program to offer health care coverage to more patients, it remains disappointing that an increase to California’s woefully inadequate Medi-Cal provider reimbursement rates was not included," said CMA President Luther F. Cobb, M.D.

“With over 12 million people to be enrolled in Medi-Cal, it is more important than ever to ensure that the program is adequately equipped to handle new patients. California pays some of the nation’s lowest Medicaid reimbursement rates and in order to properly serve the poorest and most vulnerable patients among us, at a minimum, a restoration of the provider cut made in 2011 needs to be restored.”

California's Medi-Cal rates often do not even come close to the cost of providing care. Medi-Cal physicians are currently paid roughly $16 for a regular, primary care visit. For many practices, this is simply unsustainable.

This issue is compounded by the fact that just last week, the Affordable Care Act's (ACA) bump in Medi-Cal reimbursement rates for primary care physicians ended, resulting in, on average, a 60 percent decrease in reimbursement rates overnight. Many primary care physicians that were able to take on new Medi-Cal patients with the ACA's primary care rate increase will no longer be able to do so, despite the increase in patients and demand for care.

Now that the Governor has released his proposal, the Budget Committees in both houses of the Legislature will begin considering it in the next few weeks. CMA and other stakeholders will continue to work with the Legislature and administration to address the woefully inadequate provider rates that are severely impacting access to timely and quality care for Medi-Cal beneficiaries, especially new enrollees.

“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," said Dr. Cobb.

For more information on the Governor's budget proposal as it relates to health care, see CMA's budget summary (members only).

Contact: Eduardo Martinez, Associate Director, Government Relations, emartinez@cmadocs.org.


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