March 16, 2017
Area(s) of Interest: Access to Care Health Care Reform
The California Medical Association (CMA) and the California Dental Association (CDA) today unveiled a budget proposal to improve access to medical and dental care for the state’s 14.3 million Medi-Cal and Denti-Cal patients. By appropriating the revenues generated by the California Healthcare, Research and Prevention Tobacco Tax Act of 2016 (Proposition 56) that come from tobacco company profits, the state can honor the will of California voters to improve access to care.
Gov. Jerry Brown’s 2017-18 current budget proposal takes $1.2 billion of tobacco tax funds that were intended to improve access to care and instead, uses them for state general fund purposes. The Legislative Analyst’s Office report on Prop 56 points out that this use of tobacco tax funds goes against the “common sense view” of the initiative’s non-supplantation provision and would be subject to legal challenge. The governor’s proposal conflicts with the plain language of the tobacco tax initiative and does nothing to improve access, coverage or care.
“Voters approved Proposition 56 with the intent that funding would go toward increasing access to care,” said John Blake, D.D.S., executive director of Children’s Dental Health Clinic of Long Beach. “I know the challenges providers face in trying to meet the needs of patients enrolled in the Denti-Cal program, and the most valuable way to use this funding is to help ensure enrollees can access a provider in a timely manner.”
CMA and CDA’s proposal focuses on targeted Medi-Cal and Denti-Cal investments to increase the number of doctors — both physicians and dentists — who participate in these programs and enable them to accept more patients in order to improve the amount of and access to care provided in California. The plan is fiscally prudent — providing supplemental payments based on a sliding scale to correspond with a provider’s level of participation in the Medi-Cal and Denti-Cal programs without exceeding budgeted special funds.
By tethering the supplemental reimbursements directly to the percentage of Medi-Cal or Denti-Cal patients a physician or dentist serves, the plan will produce measurable results for patients; be straightforward for the Department of Health Care Services to administer; and can be implemented regardless of Medicaid funding decisions on the federal level. Most importantly, it will directly increase access to treatment and services for patients who face significant barriers to care.
“As a physician who has seen firsthand the escalating numbers of patients unable to find a doctor who can viably accept them into their practice, it is clear that the tobacco tax must be put to its intended use of increasing patient access,” said CMA President Ruth Haskins, M.D. “This proposal honors the will of the voters and the letter of the law for common sense investments in the Medi-Cal system that will result in vulnerable patients gaining timely access to care.”
California’s Medi-Cal and Denti-Cal provider networks suffer from chronic underfunding that directly affects patient care. California provider rates are among the lowest in the nation – 48th of 50 states. As a result, only 20 percent of dentists in California are able to accept Denti-Cal patients and 16 California counties either have no Denti-Cal providers, or none accepting new patients. Forty percent of California physicians provide 80 percent of Medi-Cal visits. Since California’s Medi-Cal and Denti-Cal programs are the nation’s largest, covering more than a third of California’s residents and 60 percent of children, the state needs a robust provider network to meet the medical and dental needs of these 14 million Californians.
CMA and CDA’s proposal is a common sense solution that targets investments to strengthen California’s Medi-Cal and Denti-Cal provider network and improve patient access to care. Fulfilling our promise to tobacco tax voters will lead to better health outcomes for Medi-Cal and Denti-Cal enrollees and result in long-term savings to the state.
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The California Medical Association represents the state’s physicians with more than 43,000 members in all modes of practice and specialties. CMA is dedicated to the health of all patients in California. For more information, please follow CMA on Facebook, Twitter and YouTube.
The California Dental Association is the non-profit organization representing organized dentistry in California. Founded in 1870, CDA is committed to the success of our members in service to their patients and the public. CDA also contributes to the oral health of Californians through various comprehensive programs and advocacy. CDA’s membership consists of more than 27,000 dentists, making it the largest constituent of the American Dental Association. For more information, visit cda.org.