Expansion of Safety Net Sparks Debate

by David Gorn

TOPIC ALERT:

The 17 health care clinics run by the Molina Medical Group, which care for many low-income patients, should qualify as safety net providers in California, according to the group's owners. AB 2002 by Gil Cedillo (D-Los Angeles) would redefine the state's process for establishing Medi-Cal safety net providers to allow centers like Molina's to be included.

"This bill would create a fair definition of a safety net provider," according to Gilbert Simon, a physician at Sacramento Family Medical Center who testified at an Assembly Committee on Health hearing earlier this week. Sacramento Family Medical Center is a Molina Healthcare partner. Molina Healthcare is a for-profit company operating in 16 states and headquartered in Long Beach.

"Physician groups across the state are preparing and building sustainable networks to provide medical homes to patients [for the expansion of health care enrollment in 2014], and it is imperative that we acknowledge the true nature of the safety net," Simon said, "and take steps to acknowledge its expanding role."

But that's not so simple, according to Sarah Nichols of Service Employees International Union California. "We are in strong opposition to this bill," Nichols said. "A case has not been made for changing this algorithm. That needs to happen in the context of the budget and overall health care reform, not in this particular forum."

Doug Kim, deputy director of legislative affairs for the California Primary Care Association, said that the real issue is that the safety-net definition is based on the central mission of providers.

"This bill may be premature," Kim said. "This bill would expand the definition to include private, for-profit entities."

Brianna Lierman Hintze, legislative representative for the Local Health Plans of California, took it a step further.

"This bill has broader policy implications that should be discussed in a broader context," Hintze said. "This bill doesn't just identify safety-net providers, but it redefines safety-net providers. Opposition is based on the identification of Molina clinics as safety-net providers. … This contravenes the safety net default mechanism. … It would allow Molina to pad its safety-net numbers."

Assembly health committee chair Bill Monning (D-Carmel) said he would support the bill, in part because the opposition came late in the process, but would take those objections into account and revisit the measure.

"This bill has a ways to go," Monning said, "assuming it clears committee."

The bill passed committee with a 16-0 vote, and now heads to Appropriations.


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