SACRAMENTO  (AP) — Long-delayed cuts to Medi-Cal reimbursements are slated to go forward, slashing doctor and medical worker payments by 10 percent, and promising to save the state $387 million, according to state advocates.

Doctors and other opponents have argued that the controversial cuts make caring for poor and disabled patients less financially viable than ever, and the timing means the cuts will coincide with the expansion of Medi-Cal, California's Medicaid program, under federal health care reform.

In June, a federal appeals court ruled that the cuts can proceed after two years of being held up by a lawsuit, according to the Los Angeles Times.

The state Department of Health Care Services said the cuts begin being phased in next month and are due to be fully implemented by January.

The first to be hit will be dentists and medical transporters on Sept. 5. Medical equipment providers will see cuts starting Oct. 24. Doctors, pharmacists and nursing facilities will follow on Jan. 9.

Some allowances will be made for expensive drugs and treatments, such as nonprofits that provide extensive dental surgery to children in rural areas.

State health care services spokesman Norman Williams said the cut is an important way to maintain "fiscal discipline."

"The decision to make these reductions was a difficult choice, but necessary to address the state's budget issues," he told the Times.

The cut was supposed to take effect in 2011 but was delayed by the lawsuit. As a result, the state will retroactively collect money from many health care providers.

Opponents say the cuts are also unnecessary because of California's improved budget.

With payments dropping, advocates worry there won't be enough doctors to care for the increasing number of Medi-Cal participants under President Barack Obama's health care overhaul.

"We need physicians to come into the program more than at any time before," Lisa Folberg, vice president of the California Medical Association, told the Times.