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Doctors, Lawmakers Renew Push to Increase Medi-Cal Payments

Andrew Nixon / Capital Public Radio

Andrew Nixon / Capital Public Radio

California lawmakers say they don't just want to reverse the 10 percent reimbursement cuts to doctors under Medi-Cal. Two identical bills, SB243 and AB366, would make some Medi-Cal payments equal to compensation under the federal Medicare program.

In some cases, that would increase payments to as much as three times the current Medi-Cal rate for a typical doctor visit.

"It's not just because we want to drive a Mercedes. I drive a Kia, a second-hand one," says Dr. Luther Cobb, President of the California Medical Association, with a laugh.

Cobb says California's Medicaid rates are among the lowest in the nation.

"When we see a patient in this program it doesn't pay for us to keep the office open," he says.  

Doctors say Medi-Cal pays a little more than $16 for a commonly billed patient visit.

Democratic State Senator Ed Hernandez is carrying one of the bills. He says if the rates were higher, more doctors may see more Medi-Cal patients.

"There are supposedly enough providers that take Medi-Cal, but there are not enough providers that take [patients] in the areas with the greatest needs. So we need to do whatever we can to make sure we increase the number of providers and I think that can be done by increasing the rates," he says.

The California Department of Health Care Services says many California doctors are in the Medi-Cal system. But they decide how many, if any, Medi-Cal patients they will serve.

The governor's proposed budget for next fiscal year increases general fund spending on Medi-Cal 4.3 percent to $18.6 billion. It estimates that 12.2 million Californians will be enrolled in Medi-Cal during that time.

The Governor's office says a provider pay increase is not in the proposed budget.

But Hernandez says he would like the governor to explain why there is "a priority for other issues, and not health and human services."

"I... feel that we at least have to have the conversation," Hernandez says.   


Pauline Bartolone


Pauline Bartolone has been a journalist for more than 15 years, during which she was Capital Public Radio’s healthcare reporter from 2011-2015. Her work has aired frequently on National Public Radio.  Read Full Bio 

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