California Community

More Pressure on Providers in Face of Medi-Cal Expansion

Aimee Sharp
Author | Shield HealthCare
03/07/15  12:53 AM PST

By Julie Small for KQED’s The California Report

Medi-Cal — the public health insurance program for low-income Californians — is growing faster under federal health care reform than the state expected. Twelve million residents — nearly a third of the state’s population — now rely on Medi-Cal, and that’s increased pressure to find more doctors willing and able to treat patients for what has historically been low reimbursement rates.

At the LifeLong Clinic in West Berkeley most of the patients waiting to see a doctor are on Medi-Cal. Among them, 26-year-old Amanda Hopkins, says she enrolled half a year ago when the state expanded the benefits program.

“It’s been relieving to have Medi-Cal and know that if something happened — I needed an ambulance or there was an emergency — I wouldn’t have to worry about being in debt thousands of dollars,” she said.

Hopkins says before she would not have gone to the doctor. “It’s nice to have this option, although it’s been taking a long time to be able to get an appointment.”

Hopkins says she had to wait five weeks for her first doctor’s visit.

Clinic medical director Dr. Davi Pakter says the long wait is one side effect of adding nearly three million people to Medi-Cal since January, 2014. At his clinic, the patients with the greatest need are seen first.

“We try very hard to arrange our schedules so that we can accommodate folks that are in urgent need,” he said, “and try to avoid sending folks to the emergency room — which is a much higher cost and usually not in the best interest of the patient.”

Pakter says that means people who need a check-up or treatment for a less urgent condition can end up waiting one to two months.

A lot of Medi-Cal patients are turning to federally subsidized clinics like LifeLong because private practice doctors won’t accept Medi-Cal insurance.

Read the Full Article at KQED’s The California Report.