Opinion: Medi-Cal: Community-based pharmacies face uncertain future with budget cuts

How can California ensure that current and future Medi-Cal enrollees maintain adequate access to essential health care?  It starts with making sure that Medi-Cal providers are sufficiently reimbursed for providing services to patients.  But California’s recent proposal to cut all Medi-Cal provider reimbursements by 10 percent will undoubtedly cause some providers to drop out of the program.

My organization, the Greater Sacramento Urban League, seeks to empower people to learn new skills, to find quality employment, to raise strong families and to build thriving communities. There’s a very old saying that goes something like: “It is difficult to philosophize when you have no food to eat.”  The same is true here: It is difficult to help families and individuals achieve self-sufficiency and equality when they do not have access to basic health care services.

The Urban League is very concerned that the additional proposed cut to Medi-Cal reimbursement rates will disproportionately impact urban and ethnic communities. That’s because Medi-Cal serves low-income families and a high percentage of those families are African Americans and Latinos. 54 percent of Medi-Cal patients are Latino and the percentage of Medi-Cal enrollees who are African-American is 53 percent higher than the percentage of African-Americans in the state’s overall population. (9.5 percent of enrollees versus 6.2 percent of Californians.)

According to the state Department of Health Care Services, there are more than 315,000 Medi-Cal enrollees in Sacramento County, more than any other county north of Riverside.  It can be difficult for people who rely on Medi-Cal to obtain the  services for which they are eligible, especially in low-income areas, due in part to reimbursement rates that don’t cover providers’ actual costs. As health care providers choose not to accept Medi-Cal, options for routine preventative care become harder to find. This in turn contributes to excessive use of emergency rooms for basic care, driving Medi-Cal program costs even higher.

Community-based pharmacies play an important role in filling this gap in our health care delivery system.  Not only do they dispense medications and over-the-counter medical products, but they provide consultative care and advice, all at a relatively low cost to Medi-Cal. Especially in low-income communities, the pharmacy is the place where many people have their most frequent contact with a health care professional. It may be the place they receive flu shots, check their blood pressure, and get advice on treating a cough or a fever. Medi-Cal’s current reimbursement rates fall short of covering costs for many services. An additional 10 percent cut will force more pharmacies to stop accepting Medi-Cal, or else cut other costs by laying off employees, reducing hours of operation, or even closing altogether.

With this 10 percent cut proposal, California lawmakers seem to be making a short-sighted decision that will only cost taxpayers more money in the long run.  Data is very clear that when access to quality health care and pharmacy services is reduced, the overall health and well-being of minority patients declines. These cuts will contribute to a situation where more families will lose access to the basic health care services a pharmacy provides, and become more reliant on expensive points of care like the emergency room. It’s in California’s best interest to reimburse pharmacies at rates that can sustain an adequate network of quality pharmacy service providers.

The Greater Sacramento Urban League urges the Centers for Medicare and Medicaid Services to reject California’s attempted 10 percent cut to Medi-Cal pharmacy providers, who play such a foundational role in keeping our families and our communities healthy.