California’s Medicaid patients lack access to health care and are therefore facing discrimination, because doctors are not being paid enough to take them. That’s the charge in a lawsuit filed Wednesday against state regulators.

The suit, filed in Alameda County by the Mexican American Legal Defense and Educational Fund, or MALDEF, among others, alleges that the state’s Department of Health Care Services has failed to monitor the problem. The issue has created a system of discrimination, especially against Latinos, according to the lawsuit.

Latinos make up roughly half of the 13.5 million Californians enrolled in Medi-Cal, the state’s version of Medicaid, according to state data. In their lawsuit, MALDEF said that as the number of Latinos enrolled into the program rose over the years, reimbursement rates to physicians who accepted the insurance fell by 20 percent. California ranks 48th in the nation in reimbursement rates, said Thomas Saenz, MALDEF president and general counsel.

Because there are so few Medi-Cal providers, Latinos and others can’t get primary or speciality care in a timely manner, said Saenz and others who filed the lawsuit.

“We must ensure that Medi-Cal is administered in a fair and non-discriminatory manner that serves the healthcare needs of Latinos and all others enrolled in the program,” Saenz said in a statement.

A spokeswoman from the Department of Health Care Services said the agency won’t comment on the lawsuit. DHCS is required by law to monitor patient access to services. But no systematic problems have been identified, according to the spokeswoman.

MALDEF has raised concerns about discrimination in the past. In 2015, MALDEF, with the Civil Rights Education and Enforcement Center, sent a letter to the state listing the same complaints. In their response, the DHCS said they found no evidence of discrimination.

“You have not alleged and we are not aware of any evidence that Latino beneficiaries are being treated differently than other beneficiaries under the Medi-Cal program,” DHCS said in a 2016 response. “Indeed, Medi-Cal rates are uniform for all providers and patients and they do not discriminate in any way on the basis of race, color, national origin or any other protected category.”

A glance through data provided by DHCS show that almost 50 percent of all grievances compiled quarterly in 2016 had to do with accessibility issues. Latinos filed about a third of those grievances. White Medi-Cal recipients filed another 30 percent.

“In the past, when Medi-Cal was a predominantly white program, access was better because the reimbursement rates were closer to other insurance reimbursement rates,” said Bill Lann Lee, senior counsel of the Civil Rights Education and Enforcement Center. “That changed when the Medi-Cal program became increasingly Latino and then majority Latino. That is discrimination.”

Given the recent discussions surrounding the Senate’s plan to repeal and replace the Affordable Care Act, Saenz said Medi-Cal is still worth fighting for, but it needs to be improved, not scrapped.

Anthony Wright, executive director for Health Access, a California-based consumer advocacy group, said people who have private insurance also can face obstacles to care, but he said those with public insurance struggle more.

Still, it’s worth saving, Wright added.

“Even though there is an issue of access, Medi-Cal is still far better than being uninsured,” Wright said. “There’s data that show Medi-Cal does provide a lot of good services and care.”


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