Pandemic SNAFU: State Mistakenly Drops Medi-Cal Coverage for Some Low-Income Californians


ANA B. IBARRA | CalMatters

As the coronavirus continues to sicken Californians, the state mistakenly terminated or reduced health insurance benefits for thousands of low-income people.

An error involving the state’s Medi-Cal program and its automated system for renewals triggered the drops in coverage— despite the governor’s executive order earlier this year that was supposed to ensure that people maintain access to safety net programs during the pandemic.

A spokesperson for the California Department of Health Care Services, which oversees the Medi-Cal program, the state’s version of Medicaid, said on Tuesday it is still assessing how many people may have been affected. But it has sent notices to 200,000 people. The department says some benefits have already been restored.

Medi-Cal provides health insurance to about 12.5 million low-income Californians.

Health advocates and attorneys who are helping affected people restore coverage say cutting people off Medi-Cal is especially risky during a public health crisis.

“This means some can’t get their prescriptions refilled or access crucial care,” said David Kane, an attorney with the Western Center on Law and Poverty.

In some instances, people were not aware their Medi-Cal was inactive until they were at a pharmacy or urgent care clinic, according to several attorneys.

In mid-March, Gov. Gavin Newsom issued an executive order that should have allowed enrollees to continue receiving safety net benefits and services, including Medi-Cal, without interruption for 90 days. That order was then extended more recently.

“These social safety net programs are so important for families — especially during this crisis,” Newsom said in announcing his original order. “We don’t want Californians who rely on these services to lose them.”

Anthony Cava, a spokesperson for the state’s health care services department, said research on the issue continues, but most of the terminations are being attributed to the program’s automated renewal system.

Under the governor’s directive, counties and the state were supposed to temporarily stop processing renewals and stop cancelling benefits effective March 17. But some people’s benefits were already scheduled to be cut off on April 1, Cava said in an email.

Medi-Cal’s computer system simply was not able to stop the automated cancellations for renewals that were past due.

Californians can be automatically dropped from Medi-Cal coverage if they fail to turn in an annual renewal packet on time, or do not submit documentation that verifies they are still eligible, health care attorneys explained.

In addition to the terminations linked to the program’s automated system, health attorneys have also identified other possible glitches.

Jackie Dai, supervising attorney with the Neighborhood Legal Services of Los Angeles County, said some people may have added their federal pandemic unemployment assistance —$600 a week— to their total household income, putting them over the limit to qualify for Medi-Cal. Or, the inclusion may have placed them at a level where they must now share some of the costs of coverage, she said.

That emergency aid should not be counted, but there is no direction or option in the renewal application alerting people to leave it out, Dai said.

The state is working to identify dropped enrollees and determine how that occurred, Cava said. He added that it is possible that the number dropped is actually smaller than 200,000, and in some cases, coverage has already been restored by the counties.

Meanwhile, attorneys with community legal aid groups say they continue to hear from people, suddenly without coverage, usually around the first of the month.

“DHCS is working with counties to assist with follow-up work to ensure that those who were removed in error are re-enrolled as quickly as possible,” Cava said.

However, some people were appropriately cut from the program, according to the department. These include individuals who voluntarily ask to leave Medi-Cal, or when a person dies or moves out of state.

People who may have been incorrectly dropped from coverage should call their county’s Medi-Cal office and ask to be restored, according to the department.

But that’s easier said than done, said Liza Thantranon, regional counsel with Legal Services of Northern California.

“It hasn’t been too difficult to get people back on once you can actually talk to someone,” Thantranon said. “But 99% of the time you can’t get a hold of them. I’ve left countless messages.”

CalMatters health care coverage is supported by a grant from the Blue Shield of California Foundation.

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