Tobacco-tax money is helping expand health care access in the Valley

As lifelong residents of the Central Valley, we are all too familiar with the need to improve health care for people in our region. Access to quality care is dismal in our hometowns because there are critical shortages of physicians and other health care professionals, particularly for low-income patients who need care.

Across the Central Valley, residents depend on the state’s Medi-Cal program for their health care. According to the California Budget and Policy Center, 50 percent of Fresno County residents are covered by Medi-Cal, but it’s a challenge to find physicians, dentists and other providers to treat these patients in a timely manner.

Although we’ve increased Medi-Cal reimbursement rates, we still don’t have enough primary and specialty doctors in the southern Central Valley. For many of these professionals reimbursement rates remain too low to accept new patients to help them pay off hundreds of thousands of dollars in student debt.

In the Central Valley, this pushes many doctors to make decisions that they might not otherwise make if looming student loan debt were not a threat, like not accepting new Medi-Cal patients.

Fortunately, California is beginning to address the need to bring more doctors and dentists to our region. In 2016, voters passed Proposition 56, which increased taxes on cigarettes and other tobacco products by $2 per pack. Now, that money is flowing back to our communities to help give doctors and dentists the financial freedom to follow their hearts and serve our local residents.

Two new programs — the CalHealthCares loan repayment program and the CalMedForce medical education program — are bridging the gap. These new initiatives are improving community health, growing a diverse provider workforce and promoting health equity right here in Fresno County and in medically underserved communities across California.

CalHealthCares offers up to $300,000 in loan repayment for physicians and dentists who make a five-year commitment to maintain a caseload of at least 30 percent Medi-Cal beneficiaries. We know that many doctors want to serve low-income patients but are often forced to make career choices based on finances. Even if students want to complete their residency in the Central Valley, students graduate from medical or dental school with huge student debt. Therefore, many graduates are less likely to treat Medi-Cal patients in the Central Valley. However, when the threat of debt is lifted, they have more freedom to care for everyone, regardless of their coverage or insurance status.

Thanks to CalHealthCares, in 2019, 15 physicians and two dentists in Fresno County received nearly $5 million to help pay off student loans, allowing them to practice in our communities without student debt looming. In return, our communities received a five-year commitment from these providers to see more Medi-Cal patients.

Concurrently, CalMedForce dedicates nearly $40 million annually to create and fund slots to train medical residents in clinics and hospitals across the state, with a focus on low-income communities. Last year, our region received more than $4 million for 23 residency slots. A new round of grants is expected to be announced later this fall.

In the last year alone, these two programs dedicated more than $100 million tobacco tax dollars to expand health care in underserved communities across the state.

The need for more doctors is most acute here at home. The Valley already has the lowest per capita ratios of licensed medical doctors, registered nurses, marriage and family therapists, licensed counselors, and licensed social workers in the state. A 2017 study by the University of California, San Francisco-Fresno Medical Education Program estimates a 4,700-clinician shortfall by 2025, with the worst shortages expected in areas including the Central Valley.

Quite simply, we need to bring more physicians to the Valley. That’s exactly what these two programs do. The two strongest predictors of where physicians will practice are where the physician finishes his or her residency training and where the individual was raised.

As a lifelong health care advocate and a physician who returned to the Central Valley to practice — now your elected representatives in Sacramento — we are committed to supporting programs that increase health care coverage to our people. We need to continue to fund programs that work and help the Central Valley receive its fair share of resources. This funding will ensure that our residents are not left behind.

When voters passed Proposition 56, they voted to raise tobacco taxes to expand access to affordable, quality health care. Access issues cannot be solved overnight, but by continuing to invest in CalHealthCares and CalMedForce, we can help close the health care gap. This will ensure that any Fresno County resident, regardless of income, can see a doctor or dentist when he or she needs one.

This story was originally published November 22, 2019 at 11:00 AM with the headline "Tobacco-tax money is helping expand health care access in the Valley."