Tue, Nov 18 2014
When it comes to expanding health coverage to its poorest residents, California could be taking two steps forward and one step back.
Even as the state celebrates its enrollment of more than 2.7 million low-income Californians in Medi-Cal in 2014, it may drop an unusually high number of beneficiaries from its rolls by year’s end.
That is because Medicaid eligibility standards relating to income and household size changed under the Affordable Care Act, forcing the 8.6 million people who had been on the program before Jan. 1 to apply under the new rules. (Medi-Cal is California’s version of the federal Medicaid program.)
Beneficiaries always have to renew their coverage annually, and there is always some churn in enrollment as people’s circumstances change. But this year, the forms asked for a host of new information, and many more people than usual haven’t responded, according to state officials, county welfare directors and advocates.
In past years, depending on the county, about 20 to 40 percent of Medi-Cal beneficiaries do not renew their coverage. But this year, the numbers are running as high as 50 percent in some counties, according to state Health Care Services Director Toby Douglas. Los Angeles County reported 38 percent hadn’t returned applications sent in August, compared to 15 to 20 percent in previous years.
Although the state isn’t yet giving out estimates, advocates say this reduced response rate could translate into as many as a million or more additional people cut from the Medi-Cal rolls this year.
On Monday, the Western Center on Law & Poverty, along with several other advocacy groups, sued the California Department of Health Care Services in Alameda Superior Court, charging that Medi-Cal beneficiaries are being unfairly dropped from coverage. The groups are also applying for a temporary restraining order to stop the state from canceling coverage for Medi-Cal recipients who haven’t been properly notified.
The problem is coming to a head now in part because the state granted people a six-month grace period past their usual renewal dates to re-enroll. In November and December, many of the renewals are coming due – and those who don’t respond are being told they will be cut off.
“A lot of people will be getting a notice right before Thanksgiving telling them that they’re losing their Medi-Cal,” says Jen Flory, a senior attorney at the Western Center on Law & Poverty. “Our concern is that a lot of them don’t really understand what’s going on and haven’t had an opportunity to provide the adequate information.”
Recipients who do not return their packets and receive a termination can be reinstated if they send in their information within 90 days.
source : As California Expands Medicaid To New Beneficiaries, Many Others Are Dropped
