CMA Advocacy Secures $1 Billion+ September 17, 2018 California Medical Association 1026 In 2016, and with a onetime $1 million investment, the California Medical Association (CMA) led a coalition of health care advocates to take on Big Tobacco to drastically expand funding for existing health programs and research into cures for cancer and other illnesses caused by tobacco products. Under CMA’s leadership, California voters overwhelmingly approved Proposition 56, which imposed a $2 per pack tax hike on tobacco products that will generate over $1 billion a year dedicated to increasing access to health care by improving provider payments and other crucial health care programs. The largest portion of Proposition 56 funds – over $500 million with an additional $500 million federal match – is dedicated to increasing provider payments in the Medi-Cal program, which serves one-third of the state’s population and half of the state’s children, so that more Medi-Cal patients can access care when they need it most. The tobacco tax funds are being used to increase payments for a total of 23 CPT codes, through both the fee-for-service and managed care delivery systems. Another $40 million will be provided to the University of California (UC) to sustain, retain and expand graduate medical education (GME) programs, with the goal of increasing the number of primary care and emergency physicians in California. This program will be administered by Physicians for a Healthy California (PHC) on behalf of the UC and in coordination with a five-member executive board and 15-member Advisory Council. PHC expects to release these funds to GME programs in the current fiscal year. The Prop. 56 tobacco tax also provided $190 million in expanded loan repayment opportunities for physicians practicing in underserved areas. Nationally, for the class of 2017, 75 percent of medical school graduates had education debt, with a median medical education debt of $180,000. CMA’s modest investment in support of Proposition 56 and its leadership in anti-tobacco initiatives, which will generate billions in new health care dollars, are part of our greater effort to combat the critical physician workforce shortage in California, which limits access to health care for patients – particularly in rural communities. Since 1856, CMA has worked tirelessly to ensure that health care professionals serving on the frontlines of medicine in our communities have a voice in the development of health care legislation, regulations and policy.