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Andrew LaMar

Sacramento – The California Medical Association launched a campaign today urging members of Congress to make important improvements in federal health reform legislation to ensure patients have the access to care they need.

Physicians across the state are contacting California’s congressional leaders and asking them to increase 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.

Health care legislation passed by the House and Senate dramatically expands eligibility for the program, meaning up to 2 million more patients could enter Medi-Cal, further hampering patient access. The program currently serves 6.5 million poor Californians.

“Increasing eligibility for Medi-Cal without increasing reimbursement rates would be catastrophic,” said Brennan Cassidy, M.D., CMA president. “Congress must fix what’s broken with Medicaid if health care reform is to succeed. Medi-Cal patients must have access to a doctor if we want to rein in health care costs and relieve overburdened emergency rooms.”

Congressional leaders are currently negotiating how to merge separate health reform bills passed by the House and Senate. California’s physicians want to make 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.

CMA is sending a delegation of physician leaders to Washington D.C. on Tuesday to meet with members of Congress.

Boosting Medicaid rates is one of six important improvements to health care reform legislation that CMA is lobbying for. The others 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.
• 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.

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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.