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Andrew LaMar

Sacramento – California physicians will visit Washington, D.C., next week to talk with congressional leaders and advocate for changes in health reform legislation that would ensure patients get the access to care they need.

“We want members of Congress to know that California’s physicians strongly support reform that fixes what is broken but preserves what is working,” said Brennan Cassidy, M.D., CMA president. “Our main concern is making sure the final bill includes the funding and framework necessary to give patients access to doctors and real health care coverage, not a false promise.”

Congressional leaders are currently negotiating over how to merge separate health reform bills passed by the House and Senate. CMA is asking to improve the legislation in six important areas to ensure real access to care. They are:

• Repealing Medicare’s flawed funding formula known as the Sustainable Growth Rate (SGR). That formula would cut funding by 40 percent in future years if left in place and would hurt senior citizens’ ability to find a doctor to treat them. The viability of Medicare is crucial as millions of baby boomers retire and enter the program. The House bill provides a funding fix, but the Senate bill does not.
• Keeping full congressional authority over Medicare instead of delegating to a committee. The Senate proposed a Medicare Independent Payment Advisory Board, which could slash spending and coverage options for senior citizens with little input from others. The House bill does not include such a board.
• Increasing Medicaid’s low reimbursement rates. As it is, patients covered by Medicaid in California, known as Medi-Cal, often struggle to find a doctor because rates are so low that only about one third of the state’s physicians participate in the program. Both bills dramatically expand eligibility, meaning up to 2 million more patients could enter Medi-Cal, further complicating access. The House bill substantially increases rates, but the Senate bill does not.
• Boosting Medicare payments in 14 high-cost California counties where many physicians are opting out of the program and seniors are having trouble accessing doctors. The House bill provides $300 million to California to update payments in those counties, which are currently classified for rural rates under the federal government's Geographic Practice Cost Index (GPCI). The Senate does not provide the adjustment.
• Improving quality reporting requirements to track Medicare treatment so they don’t mislead patients. It’s crucial that those standards provide accurate and meaningful reporting.
• Giving patients the ability to privately contract with doctors, as they have in most other countries.

“This legislation would extend health care coverage to millions of Americans who do not have it,” Cassidy said. “We want to be sure the coverage is real and patients can get the care they need, when they need it. If implemented, these six provisions will protect patient access and allow us, as doctors, to do our job.”

CMA will continue to work closely with members of California's congressional delegation on how to best implement the legislation, improve it and fix problems that arise.

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The California Medical Association represents more than 35,000 physicians in all modes of practice and specialties. CMA is dedicated to the health of all patients in California.