One of the potential casualties of an expedited process to offset a California state budget shortfall of $3.3 billion may very well be state Medicare (Medi-Cal) payments for acupuncture treatment. This is particularly troubling, as California currently is the only state to offer Medicaid coverage for acupuncture treatments.
In his submitted 2008-2009 budget, released on Jan. 10, Governor Arnold Schwarzenegger proposed a 10 percent cut across the board, including: "Reductions of $10 million in 2007-2008 and $134 million in 2008-2009 by eliminating certain Medi-Cal optional benefits including incontinence creams and washes, acupuncture, adult dental, audiology, optometry, optical, chiropractic, podiatry, psychology and speech therapy."
To make matters even worse, these cuts may very well go into effect on March 1, due to the potential budget shortfall. Gov. Schwarzenegger has declared a fiscal state of emergency and called for a special session of state legislators to address the fiscal crisis immediately, pursuant to Proposition 58, passed by California voters in 2004. Proposition 58 requires that the state legislature and the governor enact a balanced budget within 45 days of the governor declaring a fiscal emergency. Until such time as the legislature passes a budget, it's prevented from acting on other bills or adjourning. On top of all this, Schwarzenegger predicts the budget shortfall could balloon to $14 billion for the next year unless the current deficit is reduced.
In an action alert dated Jan. 11, 2008 (one day after the governor's proposed budget was released), the California State Oriental Medicine Association (CSOMA) stated: "CSOMA is currently networking with other stakeholders who would be impacted by the proposed cuts to acupuncture and other health care services in Medi-Cal in order to develop an effective strategy for challenging the elimination of these services. We will provide further updates and Action Alerts as information becomes available."
CSOMA President Greg Sperber, DAOM, BMBS, LAc, elaborated on the effect of this budget crisis on acupuncturists. He started by emphasizing that since acupuncturists who see patients on Medi-Cal only get reimbursed $15 per treatment and can only supply those treatments every other week, the cuts "are not going to do much to trim the budget." As it is, Medi-Cal payments across the board are among the lowest in the nation, prompting fears that large numbers of physicians will refuse to take Medi-Cal because the payouts are so small.
Sperber went on to say that the inclusion of acupuncture under Medi-Cal is instead "important as a political beachhead," given that California currently is the only state that has such coverage. The hope was that California could serve as a model, not only for other states, but eventually for Medicare coverage at a federal level.
Currently, CSOMA is working on outreach with other AOM professional organizations to determine how best to respond. Unfortunately, given the accelerated timeline for passing the state budget, Sperber is afraid "CSOMA is not going to have enough time to respond effectively." See the contact information below if you are interested in letting the governor and the legislature know your opinion on these proposed cuts:
Governor Arnold Schwarzenegger
Phone: (916) 445-2841
Fax: (916) 558-3160
Web Site: http://gov.ca.gov/interact
State Assembly Speaker Fabian Núñez (D-Los Angeles)
Phone: (213) 620-4646
State Senate President Pro-Tem
Don Peralta (D-Oakland)
Phone: (510) 286-1333
State Senate Republican Leader
Dick Ackerman (R-Irvine)
Phone: (916) 651-4033
Fax: (916) 445-9754
State Assembly Republican Leader Mike Villines (R-Clovis)
Phone: (559) 446-2029
Fax: (559) 446-2028