Medi-Cal 10 Percent Cuts, Patient Safety and the California Budget Surplus Crisis

  • Zakowski, Mark, MD
| Jun 02, 2013

The new 2014 Governor’s Budget for California includes nearly $1 billion in cuts to Medi-Cal — a program, which provides health care for 7 million children and adults with limited resources. The headlines make the cuts seem clean and simple, but the actual impact real Californians could experience is much more complicated.

California’s implementation of President Obama’s Patient Protection and Affordable Care Act (PPACA) is expected to place millions more Californians into the Medi-Cal program in 2014. During the California budget crisis, Medi-Cal providers received a 10 percent cut in payment rates. However, the courts deferred the cuts based upon legal challenges by the California Medical Association (CMA) and others regarding decreased access to care. After a lengthy court battle and appeals, the 10 percent rate cut was just deemed legal and Gov. Brown wishes to reclaim that “extra” money retroactive to 2012 that was paid out during the period when this issue was being considered in the courts.

How deep can the cuts go before creating limitations in access? California has one of the lowest payment rates in the country.  Physicians have seen the Medi-Cal rates decrease to the point where some have stopped accepting Medi-Cal patients at all. 56% of Medi-Cal recipients report having trouble finding a physician. Limiting access to care is the opposite of what the PPACA promises. As resources become further limited to Medi-Cal recipients, they may face delays for appointments, screenings and treatments. Yes, Medi-Cal recipients will receive care, but will it be timely? Will hindsight show us that bad outcomes could have been prevented? Many predict problems.

SB 640 (Lara) and AB 900 (Alejo) were introduced to prevent the 10 percent Medi-Cal cuts from being realized. Supporters of these bills include many physician organizations, including the CSA, CMA, unions and health insurance providers, are bonded in their resolve to maintain quality health care for Medi-Cal recipients. In addition, a new poll shows that likely voters in California overwhelmingly support California’s Medi-Cal health care safety net and oppose massive retroactive cuts. Without a coalition of unified voices, Medi-Cal patients would surely continue to see diminished access to care.

With the legal battle lost, the legislative battle has begun. Even more interesting, the current projected California budget surplus of between $1.2-4.4 Billion for 2014 will complicate the discussion, as many competing interests vie for the use of these potential funds.

What can you do?

Let you California Assembly and Senate Legislators know that you stand behind SB 640 and AB 900; tell them that you support access to quality care for all Californians, and that further cuts to Medi-Cal will certainly undermine that access.

The CMA, along with other health care advocates, are part of the We Care for California coalition to help prevent the Medi-Cal cuts that would decrease access to health care for so many. On June 4th, thousands of physicians, nurses, patients, workers and advocacy groups will meet in Sacramento to urge legislators to pass and the governor to sign these bills that would adversely affect care for Medi-Cal recipients. You know people who will be affected - estimates project that one out of every four Californians will be covered by Medi-Cal after implementation of PPACA. Take Action!

Call to Action:

Attend the Rally  | We Care for California

Who: Thousands of physicians, hospitals, dentists, health care workers, community clinics and patients

What: Rally to urge Legislature and Governor Brown to support SB 640 and AB 900; Health Fair; Live Entertainment; Free lunch.

When: June 4, 2013, 11:00 a.m. – 4:00 p.m.

Where: California State Capitol, West Steps, Sacramento, California 95814

Sign up here

Tell the CSA: CSA members attending the rally should let the CSA know (650-345-3020) or email

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