A coalition of legal advocacy groups is asking the federal government to find that California is violating the civil rights of millions of Latino Medi-Cal recipients because they must wait months and sometimes years for medical services.
They say many people on Medi-Cal have trouble getting needed care because low reimbursement rates have led many doctors to refuse to accept Medi-Cal patients.
One of the attorneys behind the complaint is Bill Lann Lee, senior counsel for the Civil Rights Education and Enforcement Center and a former assistant attorney general for civil rights.
"The lower reimbursement rate of Medi-Cal patients affects all races and groups, but make no mistake, the low rate results from the fact that the program is so heavily Latino," he said.
Lee says as the percentage of Latinos in the program has risen to two-thirds, reimbursements rates have plummeted. That, he says, means California is violating federal anti-discrimination laws because the law requires parity between Medi-Cal reimbursements and reimbursements for Medicare and employer-sponsored insurance.
"The state, through illegal actions, has undermined the increased access accomplished by the Affordable Care Act and great efforts by advocates around the state to enroll more people in Medi-Cal," said Thomas Saenz, president and general counsel for MALDEF.
The complaint also alleges lax state oversight of the program, citing studies and state audits that found delays in medical care are common and requirements for accessibility are not being enforced.
The state Department of Health Care Services oversees Medi-Cal. Director Jennifer Kent said in a statement that she can’t comment on the complaint, but added that the agency monitors access to the program and recent surveys show beneficiaries are satisfied with their services.
Maria Barba of Los Angeles was one of the speakers at the news conference announcing the federal complaint. She said she feels the program is discriminatory. She has kidney stones and multiple doctors have told her she needs surgery but that they can't do it. Medi-Cal doesn't pay enough to cover the costs, she said.
"I feel angry, it infuriates me to be going through this condition because other people with other insurance can get treated and attention from doctors and I can’t get a surgery," she said. "There is no remedy for me because I have Medi-Cal."
Advocates say payments for Medicaid, which provides funds for Medi-Cal, are supposed to be on par with Medicare, the program for seniors and the disabled. But in California the Medi-Cal reimbursement rate is less than half of that for Medicare, which places the state 48th out of 50 programs in the country, according to the civil rights groups.
There are two ways Medi-Cal rates are set. One is fee for service and those are set by the Department of Health Care Services with input from the legislature. The other is through managed care organizations, which are set by third party actuaries and approved by the Centers for Medicare and Medicaid Services, according to the Department of Healthcare Services.
The office of civil rights has six months to investigate the complaint.