State lawmakers are nearing a deal on a budget for the fiscal year that begins July 1, and the projected revenue bounty makes it possible for Sacramento to undo some of the most damaging cuts made to state programs during the economic downturn while still paying off debt and building reserves. That's good news for the state's schools, courts, colleges and universities, and
California pays healthcare providers lower rates than any other state's
It's hard to quantify the effects, but the situation in pediatric dentistry illustrates the problem. Dental care is one of the most effective forms of preventive medicine, and those who don't get it may wind up needing far more expensive treatment for more acute problems, such as abscessed teeth and infected gums. But according to the advocacy group Children Now, there's only one dentist in the Denti-Cal program for every 700 kids, and half of them won't take new patients. Four counties have no dentists that accept Denti-Cal at all.
The rate reduction has been mitigated somewhat by the state's efforts to shift Medi-Cal patients into managed-care plans, which offer more coordinated care and a more complete network of providers. Yet about 3 million Californians remain outside of managed-care plans. By driving providers out of Medi-Cal, the state will succeed in making routine care less accessible. That means more poor people will be treated for more acute problems in emergency rooms, with Medi-Cal still picking up the tab.