CMA backs new PBGH initiative to support primary care in California

May 21, 2020

The California Medical Association (CMA) has joined a coalition of physician, health care and business leaders who are calling on state lawmakers to ensure health insurance companies pay their fair share to maintain our health care infrastructure, and to ensure we emerge from the COVID-19 crisis with a health care system that can meet patients’ needs.

Before California can reopen, we must ensure that our health care system is able to serve patients who need care. Unfortunately, COVID-19 has wreaked havoc on parts of our health care system—particularly on our primary care physicians. Failure to bolster primary care at this pivotal moment could hamper California’s efforts to restart its economy. More than one-third of primary care physicians worry their practices won’t survive the economic damage inflicted from the COVID-19 outbreak. Nearly half of all medical practices have had to lay off or furlough staff, and practices have seen an average 64% decline in revenue.

As physician practices have struggled to stay open, publicly traded health insurers have continued to post robust profits during the COVID-19 outbreak. While millions of Californians continue to pay health insurance premiums, health plans have seen their expenses drop as Californians stay home, and many forego scheduled preventative and other health care services.

The Care for Californians Initiative calls on health insurance companies to use premiums that have already been paid by employers and consumers to help sustain a vital part of health care delivery. The proposal would require health insurance companies to utilize unspent premiums for emergency prospective payments. This would help ensure that primary care physicians can keep their doors open and continue to serve patients as California begins to reopen its economy. 

The proposal is backed jointly by CMA and the Pacific Business Group on Health, a not-for-profit public benefit organization based in California consisting of large public and private purchasers of health care. Together PBGH members spend nearly $100 billion each year to provide health care coverage for about 15 million Americans. They share CMA’s conviction that primary care matters, and that health care delivery anchored in primary care saves money and improves patient outcomes.

The Care for Californians Initiative ensures that California can get back on its feet, and that residents maintain access to important health care services — including well-child visits, immunizations, behavior and mental health and gynecological examinations — at no additional cost to California taxpayers. By utilizing unspent premiums for emergency prospective payments, the state can ensure Californians have access to the critical primary care services they need, so California can get back to work.


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