{"id":273885,"date":"2024-05-26T23:05:00","date_gmt":"2024-05-27T06:05:00","guid":{"rendered":"https:\/\/timesofsandiego.com\/?p=273885"},"modified":"2024-05-27T06:58:03","modified_gmt":"2024-05-27T13:58:03","slug":"deficit-driven-budget-cuts-will-hit-california-health-care-providers-hardest","status":"publish","type":"post","link":"https:\/\/timesofsandiego.com\/health\/2024\/05\/26\/deficit-driven-budget-cuts-will-hit-california-health-care-providers-hardest\/","title":{"rendered":"Deficit-Driven Budget Cuts Will Hit California Health Care Providers Hardest"},"content":{"rendered":"\n
\"Alvarado<\/a>
A hospital emergency room entrance in San Diego. Photo by Chris Stone<\/figcaption><\/figure>\n\n\n\n

The single largest cut in Gov. Gavin Newsom<\/a>\u2019s latest budget proposal threatens to undo a multibillion-dollar deal he made with health care industry leaders last year to shore up the state\u2019s expansive public insurance program with a new tax. <\/p>\n\n\n\n

Newsom wants to take $6.7 billion that had been earmarked for increased Medi-Cal<\/a> payments to health care providers and instead use it to help plug the ballooning state deficit<\/a>. Providers last year agreed to be taxed<\/a> to generate that money with the stipulation that it be invested in Medi-Cal, the state\u2019s insurance program for lower-income households.<\/p>\n\n\n

\n
\"CalMatters<\/a><\/figure><\/div>\n\n\n

Newsom said his budget proposal preserves core services for programs like Medi-Cal and emphasized that his administration has expanded services \u201clike no other state in U.S. history has ever expanded.\u201d<\/p>\n\n\n\n

\u201cWe are maintaining that,\u201d Newsom said during a recent budget presentation.<\/p>\n\n\n\n

Groups representing doctors, hospitals and patients warn the cut would weaken an already overburdened health care system that serves one-third of the state\u2019s population. Industry groups have gathered signatures<\/a> to place a measure on the November ballot<\/a> that would overrule any cuts made in the state budget and to prevent Newsom and future governors from repurposing Medi-Cal funds.<\/p>\n\n\n\n

\u201cWe are deeply disappointed that the governor\u2019s proposal jeopardizes access to health care for millions of Californians,\u201d the Coalition to Protect Access to Care<\/a>, the group supporting the ballot measure, said in a statement.<\/p>\n\n\n\n

The coalition is the same group that brokered last year\u2019s deal \u2014 known as the Managed Care Organization, or MCO, tax \u2014 and is primarily supported by the California Medical Association, California Hospital Association, ambulance operators, Planned Parenthood Affiliates of California and health insurers. <\/p>\n\n\n\n

Under the original deal, the health insurance plans serving Medi-Cal patients would get taxed in order for the state to claim a dollar-for-dollar matching amount of money from the federal government. The promise was that the money generated \u2014 upwards of $35 billion for the state over four years \u2014 would be invested in the Medi-Cal system to increase reimbursement rates<\/a> and attract doctors and other providers who otherwise say they don\u2019t get paid enough. <\/p>\n\n\n\n

Instead, Newsom\u2019s new proposal increases the tax on health plans, uses the new money to alleviate the deficit, and cancels planned Medi-Cal rate increases for emergency room doctors, specialists and certain other providers. Increased payments that started in January for primary care, obstetrics and mental health would not be touched.<\/p>\n\n\n\n

\u201cThis is mind-boggling for the public, but really the story is about equality,\u201d said John Baackes, chief executive of L.A. Care Health Plan, the largest publicly operated health plan in the country. <\/p>\n\n\n\n

For the past decade, California lawmakers have steadily restored Medi-Cal services cut during the Great Recession, added new ones, and expanded eligibility to include all low-income Californians regardless of citizenship<\/a>. Today Medi-Cal covers things like dental exams, hearing aids, doula services and acupuncture. It is one of the most comprehensive public insurance plans in the country.<\/p>\n\n\n\n

Expanding Medi-Cal access<\/h3>\n\n\n\n

L.A. Care serves more than 3 million Medi-Cal members in Southern California. Between January and March, more than 164,000 new members were enrolled when California granted Medi-Cal to working-age, undocumented immigrants. But increasing enrollment and benefits without providing more incentives to providers has strained the health system to a breaking point, Baackes said.<\/p>\n\n\n\n

\u201cNobody is saying that the state doesn\u2019t have a (budget) problem. We know they have a problem, but the cost that\u2019s going to be paid by the people who benefit from the Medi-Cal program is very difficult for the providers to accept,\u201d Baackes said.<\/p>\n\n\n\n

\"\"
Gov. Gavin Newsom addresses the media during a press conference unveiling his revised 2024-25 budget proposal at the Capitol Annex Swing Space in Sacramento on May 10, 2024. His proposal includes a change to the so-called MCO tax on California health care services. Photo by Fred Greaves for CalMatters<\/figcaption><\/figure>\n\n\n\n

In recent budget hearings, representatives from the Newsom administration said they were trying to protect Medi-Cal\u2019s core services while balancing a $27.6 billion deficit.<\/p>\n\n\n\n

\u201cThese decisions and proposals are difficult and not put forward lightly,\u201d said Michelle Baass, director of the Department of Health Care Services, which oversees Medi-Cal, during a recent Assembly budget hearing.<\/p>\n\n\n\n

At that hearing, lawmakers who approved the tax deal last year accused the administration of not being honest about how the money would be used. <\/p>\n\n\n\n

\u201cI\u2019m just wondering if any of the discussions we\u2019ve had about the shortages, the closures, the issues that we have on the ground, the workforce shortages, if any of those things came into thought as you were trying to preserve core services, which is important, but if you don\u2019t have providers to go to, what have we done?\u201d said Assemblymember Akilah Weber, a Democrat and obstetrician from La Mesa, in the hearing. <\/p>\n\n\n\n

Looking to California\u2019s November election<\/h3>\n\n\n\n

Jarrod DePriest, president of Maxim Healthcare Services, said he was shocked to learn the \u201cdollars meant to protect Medi-Cal\u201d could be diverted. DePriest\u2019s company provides home health services, such as nurses for people who would otherwise be confined in a hospital. A majority of its clients are children with complex health needs like cerebral palsy or severe respiratory problems, DePriest said. <\/p>\n\n\n\n

Between 2018 and 2024, the number of nurses his company employs dropped by half because Medi-Cal reimbursement rates haven\u2019t kept up with salaries and inflation, DePriest said. Consequently his company serves nearly 10,000 fewer patients.<\/p>\n\n\n\n

\u201cDown the road things will get worse and worse,\u201d DePriest said.<\/p>\n\n\n\n

His group and others, like air ambulance operators, were not included in the original Medi-Cal rate deal and are fighting for some of the tax revenue \u2014 but it\u2019s unlikely with the current deficit. The proposed cuts signal to them that the state is unwilling to invest in Medi-Cal, which is exactly what ballot measure proponents hoped to avoid.<\/p>\n\n\n\n

Dustin Corcoran, president of the California Medical Association and leader of the ballot coalition, said providers will only accept more Medi-Cal patients if they are confident the state will fund the program permanently.<\/p>\n\n\n\n

\u201cMedi-Cal has been underfunded for so long, one of the things we were trying to accomplish was the predictability and stability of rates,\u201d Corcoran said. \u201cYou can\u2019t have providers in situations where they don\u2019t believe in consistency in the rates, and they have to choose between bankruptcy and patient abandonment. That shouldn\u2019t be a choice that a provider ever has to make.\u201d<\/p>\n\n\n\n

CalMatters<\/a> is a public interest journalism venture committed to explaining how California\u2019s state Capitol works and why it matters.<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"

Gov. Gavin Newsom wants to take $6.7 billion that had been earmarked for increased\u00a0Medi-Cal\u00a0payments to health care providers and instead use it to help plug the\u00a0ballooning state deficit. <\/p>\n","protected":false},"author":2,"featured_media":155015,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"MSN_Categories":"News","MSN_Publish_Option":true,"MSN_Is_Local_News":true,"MSN_Is_AIAC_Included":"Empty","MSN_Location":"[{\"longitude\":\"-117.164\",\"latitude\":\"32.7158\",\"locality\":\"San Diego\",\"subRegion\":\"San Diego County\",\"region\":\"CA\",\"country\":\"United States\"}]","MSN_Add_Feature_Img_On_Top_Of_Post":false,"MSN_Has_Custom_Author":false,"MSN_Custom_Author":"","MSN_Has_Custom_Canonical_Url":false,"MSN_Custom_Canonical_Url":"","newspack_ads_suppress_ads":false,"newspack_popups_has_disabled_popups":false,"newspack_sponsor_sponsorship_scope":"","newspack_sponsor_native_byline_display":"inherit","newspack_sponsor_native_category_display":"inherit","newspack_sponsor_underwriter_style":"inherit","newspack_sponsor_underwriter_placement":"inherit","jetpack_post_was_ever_published":false,"apple_news_api_created_at":"2024-05-26T15:31:12Z","apple_news_api_id":"eb018e86-8aa8-4137-b15c-16c7de0c29bf","apple_news_api_modified_at":"2024-05-27T13:58:09Z","apple_news_api_revision":"AAAAAAAAAAAAAAAAAAAAAA==","apple_news_api_share_url":"https:\/\/apple.news\/A6wGOhoqoQTexXBbH3gwpvw","apple_news_coverimage":0,"apple_news_coverimage_caption":"","apple_news_is_hidden":false,"apple_news_is_paid":false,"apple_news_is_preview":false,"apple_news_is_sponsored":false,"apple_news_maturity_rating":"","apple_news_metadata":"\"\"","apple_news_pullquote":"","apple_news_pullquote_position":"","apple_news_slug":"","apple_news_sections":[],"apple_news_suppress_video_url":false,"apple_news_use_image_component":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"newspack_featured_image_position":"","newspack_post_subtitle":"","newspack_article_summary_title":"Overview:","newspack_article_summary":"","newspack_hide_updated_date":false,"newspack_show_updated_date":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":true,"jetpack_social_options":{"image_generator_settings":{"template":"highway","enabled":false}}},"categories":[266525],"tags":[264102,1651,33682,34795,295953,1559,30606],"newspack_spnsrs_tax":[],"coauthors":[272706],"jetpack_publicize_connections":[],"apple_news_notices":[],"yoast_head":"Deficit-Driven Budget Cuts Will Hit California Health Care Providers Hardest - Times of San Diego<\/title>\n<meta name=\"description\" content=\"Gov. 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