Separate, Unequal And Unacceptable

Access to health care is a fundamental human right

Navigating our health care system is confusing and expensive, but at the end of the day it’s much more than terms like ‘deductibles’ or ‘subsidies.’ It’s about taking care of our friends, families, and neighbors. St. John’s Well Child and Family Center provides health care services to Los Angeles’ most vulnerable communities, which is why we joined a lawsuit against the State of California that seeks to improve health care access for millions of Californians.

Medi-Cal provides health care for 13.5 million Californians― nearly one-third of the state’s population. The harsh reality, however, is that the program started paying health care providers drastically less to treat Medi-Cal patients just as Latino enrollment in Medi-Cal surged. The result is separate and unequal access to health care.

From 2000 to 2016, Medi-Cal reimbursement rates dropped twenty percent, while the number of Latinos enrolled in Medi-Cal grew by nearly five million. Because Medi-Cal reimbursement rates to doctors are so low, they only accept a small number of Medi-Cal patients. Even with Medi-Cal coverage, patients have to wait weeks―even months― for appointments and are often forced to drive long distances to find a provider. For most, this means having no primary care doctor or going to the emergency room for basic health services. The disparity in funding has created a two-tiered health care system in California: a strong one for those with private insurance and a weak one for those with Medi-Cal.

Medi-Cal is legally obligated to pay providers enough that Medi-Cal patients have the same access to doctors and clinics as people with private insurers or Medicare do. However, California never adjusted those rates to account for the increase in enrollment after the Affordable Care Act expanded access to health care for millions of Californians.

Last November, California voters approved Proposition 56, which assessed a new tax on tobacco sales and devoted that revenue to funding Medi-Cal. But the state plans to use only half to three-fourths of the funds generated under Proposition 56 to improve Medi-Cal doctor rates. Beyond the irony of using money earned from a carcinogen to pay for health insurance, the tobacco tax generates a funding pool that is insignificant and unsustainable. Ultimately, the state of California sends a clear message: MediCal, a life-saving source of health care coverage for 7.2 million Latinos, is at the whim of tobacco sales and the resulting revenue, and the lives of those enrolled in Medi-Cal are expendable.

While the lawsuit’s plaintiffs are Latino (who make up the majority of Medi-Cal patients), all Californians who rely on Medi-Cal are being harmed. The lawsuit seeks to require California to increase the reimbursement rates to doctors, and thereby ensure Medi-Cal is meeting basic standards, such as having one provider for every 2,000 participants and ensuring that providers be no more than 10 miles from a beneficiary’s residence. It would also eliminate red tape that keeps patients from seeing doctors when they need to and make doctors less willing to serve Medi-Cal patients.

The bottom line is that access to health care is a fundamental human right, albeit one that relies on our state funding. In the face of such injustice, the State of California must treat the 13.5 million Medi-Cal patients as humans, not as a budget item that is scrimped and ignored. We will continue to fight for all of our patients and make sure that all Californians gain equal and timely access to health care.