California wants to pay doctors more money to see Medicaid patients

SACRAMENTO, California: When Hunter Morgan acquired an optometry practice in Southern California, he aimed to serve all patients, including Medicaid beneficiaries.

However, just months later, he had to halt Medicaid services due to inadequate pay, leaving many low-income patients without access to eye care.

California’s Medicaid program, known as Medi-Cal, covers approximately 15 million residents but struggles to keep up with doctor payment rates. This disparity has strained rural hospitals and exacerbated the challenge of finding Medicaid providers, prompting patients to travel long distances for care.

To address this issue, Governor Gavin Newsom and state legislators have turned to an unconventional solution: taxing managed care organizations. Last year, a law was passed to significantly increase this tax, generating billions in revenue earmarked for Medicaid.

"California is pulling every lever of government to increase access to affordable, high-quality health care across the state," Newsom said in a statement to The Associated Press.

Newsom plans to allocate a portion of this revenue to raise doctor payments, starting with primary care physicians and expanding to include services like optometry. Under the proposed changes, optometrists could see their Medicaid reimbursement rates increase from $47 to $130 per exam, bringing relief to both providers and patients.

While providers welcome these increases, concerns linger about funding sustainability amid California’s growing budget deficits. Potential federal limitations on Medicaid taxes may further complicate the state’s ability to maintain higher doctor payments.

"If things really did get bad, I think, they could use the money for other purposes," said Kristine Schultz, executive director of the California Optometric Association.

Despite these challenges, California Democrats remain committed to boosting Medicaid rates, viewing it as essential for expanding access to healthcare. Republicans, however, question the plan’s long-term viability and worry about potential diversions of funds away from healthcare.

For communities like Fresno, where Medicaid patients face limited access to eye care, increased doctor payments offer hope for improved services. Practices like Fogg Remington, which ceased accepting new Medicaid patients due to low reimbursement rates, could reconsider their decision with higher payments.

Dr. Anthony Chavez of Fogg Remington sees increased rates as a win-win, enabling providers to fulfill their mission of serving vulnerable populations while sustaining their practices. "We want to help these people," Chavez said.