Picture of Ciara Harraher, MD

Ciara Harraher, MD

CANS President

President's Message

Over the 13 years that I have been in practice in Santa Cruz, I have seen a dramatic decrease in the number of physicians that see Medi-Cal patients. This problem is likely to worsen with the recent claw back in promised provider rate increases announced by the Governor last week.

Newsom wants to take $6.7 billion that had been earmarked for increased Medi-Cal payments to health care providers and instead use it to help address the state deficit. Under the original deal, the health insurance plans serving Medi-Cal patients would get taxed so that the state could claim a dollar-for-dollar matching amount of money from the federal government. The promise was that the money generated — upwards of $35 billion for the state over four years — would be invested in the Medi-Call system to increase reimbursement rates which would enable more doctors to see Medi-Cal patients.  Many state that they simply can’t afford to keep their practices going with their current reimbursement rates.

I looked up the statistics for my county and in 2022, nearly 20 % of the population was on Medi-Cal. With the more recent expansion of Medi-Cal to include working age, undocumented workers it is likely that this number is even higher today.

So, we have great enrollment with less uninsured patients but not enough physicians that can take care of them. And those that do (like me) see our payor mix tilting even more heavily towards Medicare/Medi-Cal.

I wonder if eventually academic centers and the larger groups that do provide care to Medi-Cal patients will stop as well. Then what? Will physicians be “forced” into it? Will the state mandate that all physicians with a California Medical License provide a certain proportion of services to the Medi-Cal system? That will not help with the already significant number of doctors leaving the state.

So, Gov. Newsom you may have made a big mistake here. Everyone has a breaking point and with this recent broken promise, the physicians in California may be reaching theirs.