By Edward Henderson, California Black Media

Prop 35 would make the state pay doctors more money for treating patients who are covered by Medi-Cal, California’s version of the federal program Medicaid, and fund other health care services, including community clinics, hospitals, ERs, family planning, and mental health providers.

Managed care organizations contract with the state to provide these health benefits. The state taxes these organizations to help pay for the Medi-Cal program. This measure would require the state to use a portion of that tax money to increase how much Medi-Cal pays doctors.

While Medi-Cal coverage has expanded significantly over the past 10 years, payments to doctors and other providers have not kept pace. According to a report by the Kaiser Family Foundation, California’s reimbursement rate is in the bottom third nationally. Because of this, many providers won’t treat Medi-Cal patients.

Supporters of the proposition argue that tax revenue from the Managed Care Organization Tax (which historically has offset fund spending on Medi-Cal) should be spent for new investments in Medi-Cal rather than the general fund to ensure providers are properly compensated for the expanded services they’re expected to cover. Over the next four years, this tax is projected to generate upwards of $35 billion.

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California Black Media spoke with Francisco Silva, CEO of the California Primary Care Association, who has been an avid supporter of Prop 35.

“It’s a generational opportunity to make timely access to care reality in California. We’ve done a wonderful job of expanding coverage, expanding benefits, and we’re still having challenges in the state to make sure people can see a physician, a nurse, timely to care in the emergency room and it’s because the lack of stable funding. So, it’s an opportunity to secure access for funding for health care the way it was meant to be.”

More than 15 million Californians are enrolled in Medi-Cal, representing more than one third of the state’s population. However, the lack of funding for medical professionals creates a lack in service that can have devastating impacts on patients who need care immediately.

“In some areas of the state, wait times to get a mammogram for instance is six months a year. That’s the difference between life and death for many people,” Silva noted.

No official campaign to oppose Prop 35 has been organized and no argument against the measure has been submitted to the Secretary of State’s office. However, Gov. Gavin Newsom has said publicly that he opposes the proposition, arguing that funding from the Managed Care Organization Tax is pivotal for other needs within the California Budget.

“This initiative hamstrings our ability to have the kind of flexibility that’s required at the moment we’re living in,” said Newsom during a press conference in Sacramento. “I haven’t come out publicly against it. But I’m implying a point of view. Perhaps you can read between those many, many lines.”

A “yes” vote supports permanently authorizing a tax on managed care organizations based on monthly enrollees, which is set to expire in 2026, and requiring revenues to be used for increased Medi-Cal programs.

A “no” vote opposes permanently authorizing a tax on managed care organizations based on monthly enrollees, thereby allowing it to expire in 2026.

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