Editorials

Deep cuts to health programs proposed by Gov. Gray Davis to help fill a $23.6 billion budget hole unfairly target those who need state help the most, California health care officials and advocates for the poor said Wednesday. 

If approved by the Legislature, the governor’s 2002-03 budget proposal would amount to $1.1 billion in cuts to the California Health and Human Services Agency. 

“Even before these cuts were announced, California’s health care system was beginning to unravel,” said Dr. Jack Lewin, chief executive officer of the California Medical Association. “This insult is particularly devastating to the hospitals, the emergency rooms and the physicians who are trying to keep it all going.” 

Davis proposed Tuesday a $98.9 billion budget that uses tax increases, borrowing and $7.6 billion in program cuts to fill the expected shortfall. Health programs would bear the largest brunt of the cuts. 

The plan would slice more than $750 million in state payments for Medicaid, known as Medi-Cal in California, and postpone a plan to expand to parents the state’s Healthy Families insurance program for poor children. Cutting Medi-Cal also will cost $350 million in lost matching funds from the federal government, health experts said. 

California Health and Human Services Secretary Grantland Johnson called the cuts “painful” but defended the plan, saying Davis spared programs that insure poor children, even funding expected enrollment increases for children in Healthy Families and Medi-Cal. 

“He took a surgical approach, frankly, and really kept the core fundamentals of those programs in place,” Johnson said. 

But health care experts and patients said doctors may refuse to take Medi-Cal patients because the average reimbursement rate for treating them will dip from $20 per office visit to $16, the same rate as 1985. Plus, they said, already crowded emergency rooms will be filled with patients who can’t find a primary care doctor or specialist who accepts Medi-Cal. 

“We are regressing,” said Dr. Dinesh Ghiya, a pediatrician in Whittier, who said he may have to stop seeing Medi-Cal patients. “Patients will be left without treatment and there is no commitment here for the poor.” 

In Los Angeles County, the proposed cuts will take $17 million from the health department that runs six hospitals and about 30 clinics, according to John Wallace, director of intergovernmental relations at the Los Angeles County Department of Health Services. 

“This means that our already serious fiscal situation is worse,” Wallace said. “More people in L.A. County will be uninsured. You’re not just looking at people waiting longer, some people won’t get seen.” 

One in four people in Los Angeles County, or 2.5 million, don’t have health care, Wallace said. 

“It’s going to make access to health care difficult,” said Beryl Kendrick, a nurse at Compton Clinic, which is going to close at the end of June because of budget deficits within the Los Angeles County’s Department of Health Services. “We’re a county clinic; we serve people who have no insurance of any sort. During time of immunization, this place is packed.” 

Juana Leon, 45, a patient at the Compton Clinic who said she has eight children, is one of those patients. 

“It would be difficult, I would have to work for the insurance and I can’t because of the problems of finding a baby sitter,” Leon said. 

Compton Clinic is one of five clinics that have been cut because the health department was already suffering a $365 million shortfall before the proposed state cuts. 

“It’s hard, all these private hospitals don’t want to take Medi-Cal as it is,” said Dolores White, a Compton resident. 

The Davis plan also would: 

— Eliminate dental, chiropractic, podiatry and acupuncture services for adult Medi-Cal recipients and cut the number of dental visits for children from twice to once per year. 

— Increases the income requirement for two-parent families with children enrolled in Medicaid. 

— Postpones a program that was to begin July 1 to allow school districts to automatically enroll students who are on free and reduced lunch programs into Medi-cal. 

— Reinstates a requirement that Medi-Cal recipients fill out forms quarterly, instead of the current once a year, to remain eligible for the program. 

Associated Press writer Sandy Yang in Los Angeles contributed to this report.