MEDI-CAL: Reimbursement Rates Should Be Increased
While California experiences "unprecedented prosperity," the state's community-based clinics "should be sharing in the ... economic boom," but "[u]p and down the state, public hospitals and clinics are closing or just hanging on," a San Jose Mercury News editorial maintains. Community clinics, which provide health care services for more than seven million uninsured Californians and 4.5 million Medi-Cal recipients, "aren't a luxury," the editorial argues. But clinics are felling a pinch because of a "combination of financial squeezes," including a drop in federal reimbursements for indigent care, rising health care costs, employers' reluctance to offer insurance and "abysmally low" Medi-Cal reimbursement rates. Although next year's state budget provides some improvements, the editorial asserts that Medi-Cal reimbursements will "remain well below the actual cost of providing care." While using the state's portion of the national tobacco settlement seems like an "obvious" solution, the editorial notes that California is putting the money into a general fund "with no guarantee much of it will go to health care." In addition, the editorial blames the low reimbursements on a funding switch from several years ago that continues to keep state money from local governments. In the early 1990s, California shifted money away from local governments into education and has kept the same funding formula ever since. Although state lawmakers have given back some of the money for specific programs and have even expanded health care programs for the poor, the editorial points out that local officials still lack financial control. While it might be too late this year for state officials to "take responsibility" for clinic and emergency room closures, the editorial warns that "next year they must seriously examine erasing the recession-era tax grab, paying back the billions taken from local governments and again increasing Medi-Cal reimbursement rates." The editorial concludes, "Prosperity has a way of covering up holes in the safety net. But we should be strengthening that safety net in our time of prosperity, not letting it unravel" (7/31).
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