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(AP) – California Gov. Gavin Newsom last year agreed to a tax increase that aimed to do two things: Help balance a budget with a multibillion-dollar shortfall, and pay doctors more money to treat patients covered by Medicaid — the taxpayer-funded health insurance program for people with low incomes that now covers one out of every three people in the state.

A year later, California is relying on this tax more than ever. Newsom raised it again in March to help cover another multibillion-dollar shortfall this year. And he’s proposing to raise it a third time to generate even more money as the deficit has continued to grow.

But many of the doctors who were supposed to see an increase in their Medicaid rates haven’t gotten it yet. Now, citing the budget deficit, Newsom wants to back out of the agreement he made with doctors last year that would have used about $5.4 billion from the tax to increase their rates starting in January 2025.

Newsom’s proposal was no surprise to California’s medical community, who have seen the state raise their rates before, only to backtrack later during an economic downturn. But doctors have something this year they haven’t had in the past: Leverage. Last week, they qualified a measure to appear on the November ballot that would force the state to pay them more for treating Medicaid patients.

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