Calif. advocates worry court-OK'd payment reductions will make it harder for poor to get care

Published on December 18, 2012 at 1:09 AM · No Comments

Some worry that a Medicaid expansion in California could be hampered by reduced payments to Medi-Cal providers that a court approved last week, making it more difficult for the poor to find specialists.

Los Angeles Times: Advocacy Groups Coming Hat In Hand To A Less-Strapped Sacramento
The California Medical Assn. also wants more funding as the state prepares to enlarge health care coverage. David Ford, the group's associate director of medical and regulatory policy, said administrators will need more staff to process an influx of newly covered Californians. "We have to be ramping up," he said. Advocates worry that the new health care law will be undermined in California because the state's Medi-Cal cuts could make it harder for the poor to get care. A federal appeals court ruled Thursday that the state can reduce payments to doctors and others who care for Medi-Cal patients; provider groups say they will appeal (Megerian, 12/17).

Los Angeles Times: Health Care Crisis: Not Enough Specialists For Poor
Many of the newly insured will receive Medi-Cal, the government plan for the needy as administered through the state of California. Clinics already struggle to get private specialists to see Medicaid patients because of the low payments to doctors. Last week, an appellate court decision that authorized the state to move forward with 10 percent cuts in Medi-Cal reimbursement, which could make finding doctors for those patients even more difficult (Gorman, 12/15).

The Associated Press: Providers: Medi-Cal Cuts Could Hurt Health Reform
Health providers and advocates for the poor say they are worried that California's cuts to Medi-Cal will hamper the state's ability to expand and improve health care under President Barack Obama's overhaul. A federal appeals court backed California's right to cut payments by 10 percent, saving the state more than $330 million a year. An attorney representing a group of pharmacies said they would appeal next week (Lin, 12/14).

CQ HealthBeat: Critics Say California Medicaid Cuts Upheld By Appeals Panel Bode Ill For Health Care Law
[E]ven if its impact is limited to California, it could have a big impact on [Medicaid] expansion under the health care law. "I can't speak to other states and whether this sets a precedent for them," said Molly Weedn of the California Medical Association in a brief interview. ... if the cuts take effect, the promise of health coverage for some 2.5 million to 3 million residents of the state amounts to a "false promise" because doctors won't be able to treat them, she said. They already are being paid the lowest Medicaid rates in the nation, even before any cuts, and couldn't keep their doors open if they accepted the state's newly covered residents, she said (Reichard, 12/14).

Other states consider new programs to extend Medicaid coverage to some residents --

The Denver Post: New Colorado Medicaid Program Helps Middle Class With Long-Term Issues
The state of Colorado agreed, expanding Medicaid in July to allow middle-class families of children with severe, ongoing disabilities to "buy in" to the insurance traditionally for the low-income. The new benefit is being used by more than 160 children. It's being paid for with funds from the hospital provider fee created in 2009 to expand Medicaid eligibility in Colorado, and federal matching money. The state says no Colorado general funds are used for the Children's Buy-In (Booth, 12/16).

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