How Can Medi-Cal Swallow a 10% Cut?

By Barbara Anderson, The Fresno Bee, Calif.

Jul. 20–California’s massive health-care program for the poor needs surgery — and even families with private insurance will soon feel the pain, experts say.

Medi-Cal, the state-federal insurance program on which more than 500,000 low-income central San Joaquin Valley residents depend, already has cut provider reimbursements by 10% in response to the state’s $15.2 billion deficit.

The cut may be rescinded. But because Medi-Cal draws more than $14 billion a year in general-fund dollars — more than any program except education — it cannot avoid reductions, officials say. And caseloads and costs continue to rise.

This will have serious consequences in the Valley, which already suffers from a doctor shortage and low Medi-Cal reimbursement rates, experts say. They fear further cuts will drive more doctors out of the area. And that will make everyone wait longer for doctor appointments.

One consumer group has begun airing a 30-second TV ad against the 10% cut. The ad by the California Health Care Partnership warns that Medi-Cal cuts could devastate Community Medical Centers of Fresno — the only Level One trauma center between Los Angeles and Sacramento.

And smaller facilities say they are even more vulnerable.

"If we go a month without getting any kind of help whatsoever, we’re looking at a possible closure of the entire facility," said Doug Skubitz, chief executive officer of Kingsburg District Hospital. The hospital already has closed its emergency room.

Everyone loses when a hospital or clinic closes. With nowhere else to go, patients turn to overcrowded emergency rooms that provide more expensive care and where people wait hours to be treated, said Anthony Wright, executive director of the nonprofit consumer-advocacy group Health Access California.

How can you preserve Medi-Cal and at the same time reduce the budget deficit?

Do you make fewer people eligible and maintain a broad range of services — dental, vision, speech therapy? Or shrink services and keep enrollment rolls wide open?

Do you charge co-payments? Or raise taxes?

Do you make the enrollment process for children’s programs more efficient? Or increase the paperwork to weed out the ineligible?

There’s little agreement on what to do. But everyone agrees something must be done.

"We all acknowledge the entire Medi-Cal system is screwed up," said Assembly Minority Leader Mike Villines, R-Clovis.

The reporter can be reached at banderson@fresnobee.com or (559) 441-6310.

—–

To see more of The Fresno Bee, or to subscribe to the newspaper, go to http://www.fresnobee.com

Copyright (c) 2008, The Fresno Bee, Calif.

Distributed by McClatchy-Tribune Information Services.

For reprints, email tmsreprints@permissionsgroup.com, call 800-374-7985 or 847-635-6550, send a fax to 847-635-6968, or write to The Permissions Group Inc., 1247 Milwaukee Ave., Suite 303, Glenview, IL 60025, USA.