Orange County Register

News flash: Poor folks don’t stop getting sick just because the state stops paying its bills.

Which puts the folks at CalOptima - the county’s $1 billion health care safety net - in a rather interesting bind:

• Stop paying medical bills - which average some $73.4 million per month (or $2.5 million per day) - until the state gets its act together, which would surely harm people?
• Or…keep paying out of pocket, by dipping into CalOptima’s reserve funds?

Drum roll, please….

CalOptima is paying. In July, August and so far in September, doctors were paid out of reserve/piggy bank/rainy-day funds to the tune of tens of millions of dollars.

But as the state’s budget paralysis wears on, “We’re depleting our reserves,” said John Moorlach, chairman of the Board of Supervisors (and CalOptima board member).

Said Michele Revelle, executive director of the Orange County Medical Association: “That’s what reserves are for.”

So doctors are happy, then, right?

Er, not quite.

To help plug that gaping hole in California’s budget, the state wants to cut reimbursements to doctors who treat the needy by 10 percent. 

So, while CalOptima is paying the bills out of its piggy bank, it’s also treating that 10 percent cut like it’s a done deal.

“We’re pleased that doctors continue to get paid while the state is in this stalemate,” said the Medical Association’s Revelle. “But in our view, (CalOptima) should not have passed on the cuts. In the end, the state may not even make any cuts to doctors.”

Perhaps, Moorlach said. If that 10 percent cut does indeed disappear, CalOptima would “catch everyone up” and repay the money to doctors. Seems to make more sense to assume the cuts are a go, than to pay full fare now and have to cut even deeper later to try to make up the difference, Moorlach said.

Some counties, of course, aren’t paying medical bills at all.

“This is a vulnerable population, and we have to make sure this vulnerable population is taken care of,” Moorlach said. “If there was to be some epidemic, it would hurt everyone.”

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