California Spurning $6M Could Hurt Medi-Cal Renewals

Viji Sundaram


From our content partner New America Media:


California led the nationwide charge in implementing the Affordable Care Act, including a provision in it that has helped a little more than 2 million more people sign up for the state’s low-income health insurance program known as Medi-Cal.


But in spring, the Brown administration turned down a $6 million grant from the California Endowment (TCE) to keep those previously enrolled, as well as those newly enrolled poor people, on the insurance program.


The grant originally was to be included in the budget but in negotiations over the May budget revision, the administration wanted it excluded. The Department of Finance argued against taking the TCE grant, saying that without renewal assistance, potentially hundreds of thousands of low-income residents would fall off the Medi-Cal rolls and thereby save the state money.


“We made a great effort to get more people into the program,” noted Anthony Wright, executive director of Health Access, a statewide health advocacy group. “It would be a shame if we can’t keep them enrolled.”


The Endowment, a private foundation that promotes affordable health care to the state’s residents, offered the no-strings-attached grant, which could be doubled with federal matching funds, with the idea that the state would give the money to community-based organizations that have been providing assisters to help people enroll in Medi-Cal.


Renewing for Medi-Cal, an annual process to reassess people’s eligibility, is no longer as easy as it once was. That’s because, starting this year, financial eligibility will be calculated on the gross income a household would report to the Internal Revenue Service. The renewal forms, health care advocates say, are complex.


“The form is terrible, but it doesn’t have to be as difficult as it is,” observed Elizabeth Landsberg, director of legislative advocacy with the Western Center on Law and Poverty. “It’s very important to keep trusted community-based organizations on the ground. We do think the funding should be accepted.”


This past April, the state began sending out renewal notices to those previously enrolled, giving them a 60-day deadline.



Medi-Cal is the state’s version of Medicaid, a publicly funded insurance program to low-income citizens, with the state and federal government equally splitting the cost. The ACA expanded Medicaid eligibility to childless adults and those with higher incomes than ever before. That allowed nearly 2 million additional people in California to sign up for the program, swelling the number of enrollees to more than 10 million. It is estimated that the number will go up to 11.5 million by next year.


Even though the federal government has agreed to pick up 100 percent of the cost to keep those newly enrolled in the program until 2016, and then phase down its support to 90 percent in 2020 and beyond, the state will continue to pick up 50 percent of the cost for those who enrolled prior to the expansion.


California hasn’t been able to cope with the expansion smoothly. The state’s web-based portal, CalHEERS, hasn’t been able to communicate with county computer systems, which do the initial processing. That initially contributed to a backlog of 900,000 applications, which the state has been able to bring down to its current 400,000. Health care advocates worry that the backlog could go up as people enroll.


But TCE’s offer is still on the table and lawmakers are determined to take advantage of it. Last month, Senators Mark Leno, D-San Francisco, and Ed Hernandez, D-West Covina, introduced SB18, that would allow the state to accept the $6 million grant, with the ability to draw down a federal match, so counties can provide additional renewal assistance for Medi-Cal beneficiaries.


The bill sailed through the Assembly earlier this week and will be reviewed by the Senate Health Committee next week before it goes to the floor for a vote.


“It’s important both from a public health aspect and also because in the long run it will save California significant funds,” Sen. Leno said by telephone, adding: “A healthy California saves the state a lot of money.”


From our content partner New America Media

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