Story by Stephanie Snyder

Low-income children in rural California communities are in jeopardy of losing their doctors and health care plans under Gov. Jerry Brown's budget proposal, state lawmakers, doctors and health advocates say.

The governor is proposing to transfer nearly 900,000 children enrolled in Healthy Families, the states Childrens Health Insurance Program, to Medi-Cal a program aimed at serving the states poorest families, seniors and disabled residents.

While combining the two programs might be a painless transition for children in urban areas with doctors who typically provide care to both Healthy Families and Medi-Cal patients, the transfer could severely limit access to health care for those on the outskirts.

In the more rural areas or outlying areas, there would be quite a loss or quite a strain, said Stuart Cohen, a San Diego pediatrician and California chairman-elect for the American Academy of Pediatrics. Access to care would be a huge issue.

And there would not be much incentive for rural doctors at full capacity to continue caring for their Healthy Families children if they have not already agreed to serve Medi-Cal patients, Cohen said.

The governors proposal not only forces Healthy Families patients to move to Medi-Cal, but it also would require doctors to accept Medi-Cals monthly reimbursement an average cut of nearly 20 percent.

Healthy Families doctors receive a monthly average of $103 per patient. They would receive an average of $84 per patient if they decide to make the switch to Medi-Cal, but California Medical Association spokeswoman Molly Weedn said the reimbursement often can be much less.

Rates that physicians are reimbursed for a Medi-Cal patient are less than what a large pizza costs, she said. Its really incredible that a physician can be reimbursed $18, $20 (per month).

A survey referenced by the Legislative Analysts Office asked pediatricians who now provide care to Healthy Families patients, but not Medi-Cal patients, if they would be willing to make the switch. The February report said 29 percent would not and 46 percent were not sure.

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Kids' access to health care a concern under Brown's budget