Governor Jerry Brown signed budget bills Thursday (March 24) containing $14 billion in cuts, including reductions in Medi-Cal and Healthy Families programs, which the California Medical Association (CMA) strongly opposed.
However, the budget bills prohibit the state from implementing the Medi-Cal cuts unless they are approved by the Centers for Medicare and Medicaid Services (CMS). CMA’s advocacy team will be doing everything possible to stop those cuts before they are implemented. CMS denied the 2008 Medi-Cal reductions, and although that issue is still under appeal, the state has not presented any new evidence that would cause CMS to change its opinion.
The cuts in the bills the governor signed included:
- A 10 percent reduction in Medi-Cal provider reimbursement rates.
- Mandatory Medi-Cal co-payments for physician office visits ($5), non-emergency use of the emergency room ($50), and inpatient hospital stays ($100 per night up to a $200 maximum). The $5 Medi-Cal copayment, never before required in California, also applies to dental and pharmacy visits and Medi-Cal prescriptions.
- A “soft cap” on physician office visits of seven per year. This is called a “soft cap” because physicians will be allowed to authorize more office visits if they feel they are medically necessary.
- Increases in premiums and co-payments for children enrolled in Healthy Families.
- Elimination of vision services in Healthy Families.
CMA succeeded last week in working with emergency physicians to remove from the budget a provision that would have taken $55 million from the Maddy Emergency Medical Services Fund, which reimburses emergency and on-call physicians and hospitals for treating the uninsured.
CMA is continuing negotiations on a compromise proposal to allow the state to obtain a federal match for a portion of the Maddy Fund, which would permit the fund to retain its core purpose of caring for the uninsured. A loss of the entire Maddy Fund would threaten access to emergency care throughout California.
All told, the Legislature has approved and the governor has signed, budget cutbacks, closing roughly half of the state’s $26.6 billion deficit. Approximately $1.7 billion of the reductions were in the Medi-Cal program. Spending also was slashed for child care, universities and colleges, libraries, transportation, state parks and prisons.
Still unresolved are the governor’s proposal to eliminate more than 400 redevelopment agencies, and the cornerstone of his budget, a measure that would ask voters to approve a five-year renewal of temporary vehicle, sales and income taxes that are due to expire July 1, 2011.
Brown is in continuing negotiations with lawmakers to resolve the remaining issues.
Contact: Carolyn Ginno, 916/551-2547 or cginno@cmanet.org.