EDITORIAL:

Dec. 24--The No. 1 health care issue facing California in 2016 is the shortage of doctors willing to treat a large number of the 12 million patients insured by Medi-Cal.

The Affordable Care Act is seen as a huge success in California because it has cut has cut the state's uninsured rate in half. But it will become a farce if physicians continue refusing to accept the abysmally low rates the state pays to treat the quarter of Medi-Cal patients who are not in managed care plans.

The problem escalated this month when civil rights activists with the U.S. Department of Health and Human Services filed a complaint saying about 7 million California Latinos covered by Medi-Cal are being denied timely access to a doctor.

It would be a huge mistake to let this evolve into a costly, embarrassing battle that almost certainly would end in a court order forcing California to comply. The state is required by law to certify that its health care plans have enough doctors available.

Gov. Jerry Brown and the Legislature need to raise Medi-Cal compensation rates as quickly as possible. It is the only way to deliver not only on the state's commitment to insured residents but also on the promise of lower public costs. As it is, poor patients who can't find a doctor still have to go to emergency rooms for care, the highest-cost treatment option.

The complaint filed by HHS's Offices of Civil Rights charges that in 2014, the government paid primary care doctors who treated non-managed-care Medi-Cal patients just 42 percent of what it paid Medicare doctors who treated seniors.

The Legislature in 2011 slashed Medi-Cal rates by 10 percent to help balance the budget during the recession. Revenue has improved, but the governor and lawmakers have not restored the cuts. The state is facing an additional $1 billion hole in its health care budget if the Legislature doesn't renew its managed care tax, which expires in June.

Brown called for a special session of the Legislature this fall to deal with these issues, but it was a failure. The tobacco lobby called in its chits and tanked a $2 a pack increase in the tobacco tax Brown had hoped to pass.

Former President Bill Clinton laid down the challenge for California more than two years ago: "If this (the Affordable Care Act) works in California, eventually America will follow your lead. If it comes off the rails here, it will give aid and comfort to everyone who really just wants to say, 'I told you so.'"

Handing out meaningless insurance policies is not making health care reform work. If Brown fails to get a tobacco tax increase and a solution to the managed care tax challenge early next year, the state will become not a model but a laughing stock. And low-income families who thought getting insurance meant getting health care will be the brunt of it.

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