Enough is enough, according to Kelly Hardy, director of health policy at Children Now.
First there was the $12 billion in state budget cuts that will hit the Medi-Cal, First Five and Healthy Families programs. More recently, a federal proposal would trim $480 billion nationally from Medicare and Medicaid.
And now state legislators are back at the drawing-and-quartering board, mulling an all-cuts budget that could slash another $15.4 billion.
"The cuts that have already been made are really devastating," Hardy said. "When you're nearly at rock bottom and there are threats to go even lower, well, that's scary to think that we could actually go lower."
Children Now is part of an organized protest scheduled Wednesday in four California locations. It's part of a nationwide protest, but it has bigger meaning in California, Hardy said, given both the recent and impending state cuts.
"This [action] is in advance of the May revise," Hardy said, "to remind the Legislature and the governor of what we stand to lose if they go forward with an all-cuts budget."
According to Stanford pediatrician Lisa Chamberlain, the children who are likely to have their care cut are the ones who need it most.
"These are the children who require coordinated multi-specialty care and are sometimes the least able to afford it," Chamberlain said. "That's the group that’s the most fragile, and that’s the group I worry about."
In the long run, one cut that could have the biggest impact might be the federal proposal to eliminate federal children's hospital funding for training pediatricians. That particular type of medical school graduate program trains about 40% of pediatricians, Chamberlain said. Already the state and the nation are facing a shortage of primary care providers, she added, at the same time as demand for primary care is about to climb.
"That CHGME [children's hospitals graduate medical education] money is gone. The training of pediatricians has been eliminated at this point," she said.
Chamberlain is less worried about the recent state proposal to cut back Medi-Cal reimbursement to physicians by 10%, because she said the courts have turned away previous attempts to lower provider reimbursement rates by similar amounts. California is already at the bottom of the reimbursement ladder and the state, she said, has run out of rungs to go any farther down.
"It's not about the reimbursement rates," she said. "As a group of pediatricians, we thought we should make a stand, and that's what we're doing."
Rallies are planned at UCLA, near UCSF, at San Francisco General Hospital and in Palo Alto, near Stanford. The nationwide event features 21 protests across 10 states, Hardy said.