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Proposition 56 Medi-Cal Funding

June 21, 2019 843

More than half of California’s children and a third of its adults — more than 13 million Californians — now rely on the state’s Medi-Cal program for their medical and dental coverage. The passage of Proposition 56 in 2016 — a tobacco-tax increase co-sponsored by CDA — has led to significant Medi-Cal funding improvements.

More than half of California’s children and a third of its adults — more than 13 million Californians — now rely on the state’s Medi-Cal program for their medical and dental coverage. The passage of Proposition 56 in 2016 — a tobacco-tax increase co-sponsored by CDA — has led to significant Medi-Cal funding improvements. Medi-Cal patients have faced major barriers to care for many years, including long delays for appointments, trouble finding specialists and having to travel long distances to receive care. A primary reason for this has been that California’s reimbursement rates to Medi-Cal providers have been among the lowest in the nation, resulting in a lack of providers who are able to participate in the program. Proposition 56 funds have helped address this in a significant way, allocating over $500 million per year on significant rate increases for hundreds of dental procedures, bringing total reimbursement for many common procedure codes to 75% to 80% of average commercial rates. The changes are producing results: The number of enrolled dentists has increased 10% since 2017 and, in combination with additional provider incentives and administrative reforms, the state is finally seeing increases in the number of children and adults receiving necessary oral health services.

The 2019-20 budget continues the current supplemental Medi-Cal provider rates through the end of 2021 and includes an additional $20 million dedicated to dentists committed to serving Medi-Cal patients in a recently launched student loan repayment program, CalHealthCares. Because of the additional funds, CalHealthCares was able to make additional awards in 2019, leading to more increases in the Medi-Cal provider workforce. While fixing the Medi-Cal program will be a long-term process, CDA is optimistic about the progress made since the passage of Proposition 56 and will continue to advocate for a long-term commitment to the current reimbursement rates. This is essential in order to provide certainty for providers and maintain stability in the program.