Medi-Cal Coverage will Grow in Valley

Fresno Bee

Health-reform bill will aid low-income people.

 

Thousands of low-income people without health insurance in the central San Joaquin Valley will have Medi-Cal coverage starting four years from now under the health-reform bill approved by Congress this week.

But they may have a hard time seeing a doctor.

The surge of new Medi-Cal patients -- estimated to be an additional 2 million people statewide beginning in 2014 -- could overwhelm an already strained health-care system, doctors say.

Exactly how many Valley residents will be added to the Medi-Cal program is anyone's guess, but more than 500,000 already are enrolled. Statewide about 7 million are served -- about half of them children.

Already, it takes many Valley patients a month or two just to get an appointment, said Dr. Alex Habibe, a Fresno internist in private practice. The influx of new patients trying to get into the waiting room will only make things worse, he said.

A survey released Friday offered some good news, showing that Valley doctors are more likely than most others around the state to accept Medi-Cal.

Seventy-seven percent of primary-care doctors in the Valley said they participate in the state-federal insurance program for the poor. And 69% of Valley specialists were Medi-Cal providers.

Statewide, 69% of primary-care doctors were in the program, and 68% of specialists participated, according to the survey, which was administered by the University of California at San Francisco for the California HealthCare Foundation.

The Valley's high participation rates reflect the high percentage of patients on Medi-Cal, said UCSF professor Dr. Kevin Grumbach, who presented the survey findings during a teleconference Friday in Sacramento.

But the level of participation doesn't fully offset the sheer shortage of doctors. Valley counties rank among the lowest in physicians per 100,000 residents, according to another report issued last year by the foundation.

"You have a reasonably high proportion of doctors participating, but just not nearly enough doctors," Grumbach said.

It's unclear how many Valley doctors now participating in Medi-Cal will accept new patients. Statewide, only 54% of primary-care physicians were accepting new Medi-Cal patients, according to the survey.

But there is good news: Doctors will have an incentive when the influx of new Medi-Cal patients begins.

The federal government plans to increase pay for primary-care doctors. Medi-Cal rates will be increased in 2013 and 2014 to match Medicare rates, which are higher, Grumbach said. Medicare is the federal government's health insurance program for the elderly.

For California doctors, that will mean about twice as much money, Grumbach said.

But that doesn't necessarily mean the pool of doctors available to Medi-Cal patients will increase.

Doctors barely get by with Medicare reimbursement rates today, Habibe said.

He has stopped accepting new Medi-Cal patients in his Fresno office but has kept his current ones.

Higher reimbursement rates will attract some doctors to Medi-Cal, but it won't solve the Valley's doctor shortage or the rates of California health insurance quotes, said Dr. Michael Lynch, a Fresno general internal medicine and travel medicine physician.

"There's not going to be enough providers -- at least not locally," he said.

Lynch doesn't accept new Medi-Cal patients at his office. He can't afford to, he said. He's not sure that will change in 2014. "In no way could I commit myself unless I knew a lot more than I do now," he said.

It's not that doctors in the Valley and California don't want to see new Medi-Cal patients, Habibe said.

"But they would have to close their offices if all they saw were Medi-Cal patients," he said, "because reimbursement is so low."