The state senator Akilah Weber Pierson plans that the California Medicaid program, known as Medi-Cal, may have to be recommended after Governor Gavin Newsom has published his last budget, which could reflect a deficit of several billion dollars.
Despite this, the doctor who has become right, who was elected to the state Senate in November, says that her priorities as president of a budgetary Health subcommittee include preserving the coverage of the most vulnerable children in the state, in particular children and people with chronic health problems.
“We will spend many hours and long nights to understand,” said Weber Pierson about the period on the deadline of June 15 for the legislators to adopt a balanced budget.
With discounts of Medicaid on the table in Washington and Medi-Cal, billions of dollars on the budget due to the increase in the prices of drugs and more awaited costs to cover immigrants without legal status, the double responsibilities of Weber Pierson-the maintenance of a balanced budget and the delivery of the compassion of state residents.
President Donald Trump said that the GOP’s efforts to reduce federal spending will not touch Medicaid beyond “waste, fraud and abuse”. Congress Republicans plan to pursue states such as California which extend coverage to immigrants without legal status and impose restrictions on providers’ taxes. Voters from California in November made the state tax permanent on health plans in care managed to continue to finance Medi-Cal.
The federal budgetary megabill is making their way through Congress, where the Republicans set an 880 billion dollar target for 10 -year spending on the Chamber Committee which oversees the Medicaid program.
Researchers in health care policy claim that this would inevitably force the program to restrict eligibility, to reduce the scope of the advantages, or both. Medi-Cal covers 1 in 3 Californians, and more than half of its budget of almost $ 175 billion comes from the federal government.
One of the rare practitioners’ doctors in the State Legislative Assembly, Weber Pierson relies strongly on his experience as a pediatric and adolescent gynecologist who treats children suffering from reproductive congenital malformations – one of the only two in South California.
Weber Pierson spoke with the correspondent of Kff Health News Christine Mai-Duc in Sacramento this spring. It has introduced invoices to improve timely access to care for pregnant patients for pregnant media, requires developers to mitigate biases in artificial intelligence algorithms used in health care and obliges health plans to cover screening for housing, food insecurity and other social health determinants.
This interview has been modified for duration and clarity.
Q: You are a state senator, you practice medicine in your district and you are also a mom. What is it like day by day?
And: When you grow up around someone who juggles a lot, it just becomes the norm. I saw this with my mother (the former member of the Shirley Weber state assembly, who is now secretary of state).
I am really happy to be able to continue with my clinical tasks. Those in the health profession understand how long, energy, efforts and money that we have spent becoming a health care provider, and I am still quite early in my career. With my particular specialty, it would also be a huge void in the San Diego region for me to step back.
Q: What are the greatest threats or challenges in health care at the moment?
And: Immediate threats are the financial problems and our budget. Many people do not understand the overwhelming amount of dollars that go to our federal government health system.
Another problem is access. Almost everyone in California is covered by insurance. The problem is that we have not extended access to suppliers. If you have insurance but your nearest work and delivery unit is still two hours, what have we really done for these patients?
The third thing is the social determinants of health. The fact that your life expectancy is based on the postal code in which you were born is absolutely criminal. Why are some areas devoid of having supermarkets where you can go and get fresh fruits and vegetables? And then we wonder why some people have high blood pressure and diabetes and obesity.
Q: At the federal level, there are a lot of conversations on the Medicaid cuts, the reintegration of the MCO tax and the decline in the subsidies of the affordable care law. What is the greatest threat to California?
And: To be completely honest with you, all. The MCO tax was a recognition that we needed more providers and to obtain more providers, we must increase the reimbursement rates of Medi-Cal. The fact that it is now at risk is very, very worrying. This is how we can take care of those who are our most vulnerable in our state.
Q: If these cuts come, what do we cut? How do we cut it?
And: We are in a position where we have to talk about it at this stage. Our Medi-Cal budget, apart from what the federal government can do, explodes. We must certainly make sure that those who are our most vulnerable – our children, those who have chronic conditions – continue to have a kind of coverage. What will it look like?
To be completely honest with you, at this point, I don’t know.
Q: How can the state make it the least painful for Californians?
And: Sometimes the last at the table is the first to leave the table. And so I think this is probably an approach that we will examine. What were some of the most recent things we have added, and we have added a lot lately. How can we cut-maybe not completely eliminate, but reduce-some of these services to try to make them more affordable?
Q: When you say the last at the table, do you talk about the expansion of medical coverage to the Californians without legal status? Some age groups?
And: I do not want to get ahead of this conversation, because it is a very great conversation between not only me but also the (president of the Senate) Pro Tem, the president of the assembly and the office of the governor. But these conversations have been had, keeping in mind that we want to provide the best care to as many people as possible.
Q: You have a bill linked to AI in health care this year. Tell me what you are trying to approach.
And: He has just exploded at a speed that I don’t know that we are waiting for. We try to play catching up, because we were not really at the table when it was all in the process of deployment.
As we progress in technology, it was great; We have extended lives. But we must make sure that the biases that have led to various differences and results of health care are not the same biases that have entered this system.
Q: How does Sacramento policy have an impact on your patients and what experience as a doctor do you bring to the development of policies?
And: I speak with my colleagues with real knowledge of what is going on with our patients, what is happening in clinics. My patients and my supplier colleagues will often come to me and tell me: “You prepare to do it, and that’s why it will be a problem. And I say to myself: “Ok, it’s really good to know. »»
I work in a children’s establishment, and just after the elections, specialized hospitals were very concerned about funding and their ability to continue to practice.
In the discussion of the MCO, I regularly heard providers, hospitals in the field. With the executive decree (on the care affirmed by the sexes for young transgender people), I saw people with whom I work concerned, because they are patients they are dealing with. I am very grateful for the opportunity to be in both worlds.
This article was produced by Kff Health News, who publishes California Healthline, an independent editorial service of California Health Care Foundation.
| This article has been reprinted by Khn.org, a national editorial room that produces in -depth journalism on health problems and is one of the main KFF operating programs – the independent source of research on health, survey and journalism research policies. |
