The same week Gov. Arnold Schwarzenegger unveiled his sweeping health reform proposal, he also issued his proposed state budget for 2007-08. Despite the governor's acknowledgement in his reform proposal that Medi-Cal reimbursement is too low, there is no provision in the budget to increase physician payments for the coming year.

California Medical Association officials are disappointed by that apparent contradiction. "California reimbursement rates are among the lowest in the country, which makes it difficult for patients to find a doctor who can afford to treat them and sustain an economically viable practice," says Anmol Mahal, MD, president of the CMA and a Fremont gastroenterologist.

Another disappointment is the lack of new funding for the Steven M. Thompson Physician Corps Loan Repayment Program, which supports doctors who agree to work in underserved areas of the state. The CMA will still ask the Legislature to include a modest $5 million allocation each year for the 2007-08 and 2008-09 fiscal years for the loan repayment program.

On the bright side, CMA leaders applaud the governor's budget provisions to improve the Medi-Cal application process and implement a Medi-Cal provider enrollment automation project. Thanks to the CMA-supported SB 437, the budget sets aside $40 million for a Medi-Cal pilot program designed to simplify Medi-Cal enrollment and re-enrollment for patients. And more than $200,000 of the budget funds will go toward a Medi-Cal provider enrollment tracking system that will help shorten the process for Medi-Cal providers.

Physicians are also pleased that the governor included $11 million in funding for HPV vaccines for female Medi-Cal recipients ages 19-26, allowing 52,000 women to receive the new FDA-approved vaccine aimed at preventing cervical cancer. Experts say that administering the vaccine could save millions in future healthcare costs.

To obtain the CMA's analysis of the governor's budget proposal for 2007-08, go to www.calphys.org/html/cc311.asp. Click on "CMA Summary of Governor's Proposed 2007-08 Budget Available."