California stakeholders urge feds to reject Gov. Brown's Medicaid cuts

Some 20 members of a broad coalition of California healthcare stakeholders met with Medicaid agency chief Don Berwick on Thursday and urged him to reject the state's request for deep cuts to the state-federal program for low-income people.

Gov. Jerry Brown has asked federal regulators for permission to cut the program by $1.4 billion to help the cash-strapped state plug its $26.6 billion budget gap. Stakeholders say the cuts would devastate a program that's critical to the success of Democrats' healthcare reform law — in California alone, the law would add 3 million people to state Medicaid rolls starting in 2014.


"It seems hard to figure out how you make federal health reform a success when you're tearing down the infrastructure on which it's dependent," Dustin Corcoran, the chief executive officer of the California Medical Association, told The Hill. "Do you want healthcare reform to succeed, or do you want to give Jerry Brown what he wants?"

California has asked for permission to make three changes to the state's Medicaid plan: a 10 percent across-the-board cut to Medicaid payments for doctors, hospitals and other providers; charging co-pays for doctor visits, prescription drugs, non-emergency visits to emergency rooms and hospital stays; and limiting doctor visits to seven per year unless a doctor certifies the need for more.

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Corcoran led the California Alliance for Patient Care delegation, which told Berwick that the state's request violates federal law requiring Medicaid payment rates to be "sufficient to enlist enough providers so that care and services are available under the plan at least to the extent that such care and services are available to the general population in the geographic area." He said Berwick seemed swayed by research detailing the effects of the state's payment rates on access to care and waiting times.

The coalition also met with aides to members of both parties representing California, asking for their support. Rep. Dennis Cardoza (D-Calif.) has separately urged Berwick to exempt facilities for people with intellectual and developmental disabilities from the cuts, The Hill reported last month.

Corcoran said the proposed cuts are so deep that Brown has managed to unite groups that are usually at odds, such as providers and insurers. 

"We can't agree on the color of the sky," Corcoran said, "but the state has bonded us together in unity."