The survey comes as disgruntled physicians who accept Medi-Cal brace themselves for more cuts to their reimbursement, and as an increasing number of doctors threaten to opt out of the program.
And it comes as most states across the country look to unload on Medicaid programs billions of dollars in cuts that must be made to balance legislative budgets.
Across the country, "people see the Medi-Cal program as kind of a bellwether," says Christopher Perrone, deputy director of the foundation's Health Reform and Public Programs Initiative. "All states are struggling with how you control spending in this program, and California has chosen one path, with historically low provider payment rates, particularly for physicians. This is a report that shows what happens when you take that course of action."
"Almost every state has significant budget shortfalls that they're struggling with now, and which they're passing on to Medicaid," says Matt Salo, executive director of the National Association of Medicaid Directors in Washington, D.C. "They can either raise revenue, which means raising taxes, and which by and large isn't going to happen, or they reduce spending."
Illinois, for example, is trying to find $2.7 billion in Medicaid savings while Arkansas is looking at a 25% shortfall, he says.