Our annual Legislative Leadership (Lobby) Day is right around the corner! If you haven't signed up to attend on Tuesday, April 15, please consider doing so right away. This is the annual trip to Sacramento to meet with our local legislators and this year is more important than ever. With the state facing a budget deficit of at least $16 billion, all doctors are needed to be in attendance to tell your stories and protect your patients. Together, we are stronger.

Already that estimate has grown. According to the state's chief Legislative Analyst Elizabeth Hill, the governor's proposal for closing the deficit is flawed, so her office took the rare step of drafting an alternative state spending plan. The independent analyst, whom lawmakers of both parties look to for advice on fiscal matters, calls on lawmakers to raise taxes by at least $2.7 billion.

The office urges them to reject Gov. Arnold Schwarzenegger's plans for a 10% across-the-board reduction in state spending, suggesting that such an approach is short-sighted. Hill argued that lawmakers instead should rank the state's expenses and eliminate those that are ineffective or duplicative. She also suggested other options, including raising $2.7 billion in additional taxes by either eliminating or reducing tax credits, such as the dependent child credit, or closing certain tax loopholes.

The Governor's plan includes a rare Executive Order, pledging to save the state an additional $100 million, including cuts to health and human services. He has asked for immediate General Fund expenditure reductions from state agencies and departments. The governor's budget included controversial plans to release prisoners early, close some state parks, suspend mandated funding for K-12 education and cut Medi-Cal reimbursement rates by 10%.

Michael Genest, Schwarzenegger's director of finance, argued that across-the-board cuts are the fairest way to reduce spending. He said reducing or eliminating tax credits amounts to increasing taxes, which the governor had refused to do. At press time, the governor made public statements that he is now considering closing some tax loopholes to generate more revenue. Former Assembly Speaker Fabian Nunez, (D-Los Angeles), said taxes will have to be part of the budget negotiations, and added that Hill's proposal to raise $2.7 billion in additional taxes is not enough.

All sides agree that the deficit has widened since Schwarzenegger declared a fiscal emergency last month. The deepening deficit is a result of lower-than-expected tax receipts in the state's three major revenue areas--personal income tax, sales tax and taxable corporate profits.

Orange County Medical Association and California Medical Association need you to participate. While we have had much success in our advocacy efforts, sometimes we need to pull out all the stops. For additional information on the annual Legislative Leadership Day, please call Jennifer Williams at the CMA Government Relations Office at 916/551-2548 or Linda Johansen at OCMA at 714/978-1160 x203. They can provide you with additional details. Most doctors fly up and back the same day, with OCMA providing transportation from the Sacramento airport to the Convention Center.

Several political pundits, along with State Insurance Commissioner Steve Poizner, have been invited to CMA's lobby day to give us the inside story. Poizner, in a move with the California Department of Managed Health Care, recently announced a joint action against PacifiCare companies, owned by UnitedHealth Group, in response to more than 130,000 alleged handling violations. This a historic step in the efforts of both the California Department of Insurance and the DMHC to put an end to the practice of unfair claims handling in the health insurance industry, and it is the first action involving both CDI and DMHC against a single health plan or insurer. Your attendance at this event will prove to Poizner that he is on the right side of this issue.

On April 15, in addition to supporting the insurance commissioner's action, we need you to demand that your legislators stop the MediCal cuts. The budget deficit solution should not be borne on the backs of doctors. Get involved. Your participation is essential for the future of healthcare access and delivery of services to your patients.