Medi-Cal

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Covered California Enrollment ‘Very Strong’ So Far

Covered California executive director Peter Lee. (Max Whittaker/Getty Images)

Covered California executive director Peter Lee. (Max Whittaker/Getty Images)

More than 290,000 people have signed up on Covered California, the state’s health insurance marketplace, officials announced Wednesday. That number includes both people who qualify for private health insurance on the exchange or Medi-Cal.

People need to sign up by Dec. 15 for coverage that starts Jan. 1.
Open enrollment started Nov. 15. Of the 130,000 people who have qualified for Covered California, nearly 50,000 of them have both completed the application and selected a plan. That compares to about 30,000 people who selected a plan during the first month of open enrollment last year.

In a press call, Peter Lee, executive director of Covered California, called that pace “very strong.” People have until Monday to sign up for coverage that will start Jan. 1. “We expect that the next few days and this weekend, we’ll see continued and even growing interest in enrollment,” Lee said. Continue reading

Map: See How Obamacare Transformed Health Insurance Coverage in California

By Ronald Campbell, CHCF Center for Health Reporting

In 2013, 6.6 million Californians lacked health insurance.

Then came the rollout of the Affordable Care Act. By April of this year, Covered California, the
state’s health insurance marketplace, had enrolled 1.4 million people, although not all of them were previously uninsured. Today 1.12 million remain enrolled. An additional 2.5 million people enrolled through July in Medi-Cal, the state’s health plan for the poor.

In the map, click on a county to see the pre-ACA uninsured rate — and the number of people who signed up for Covered California or Medi-Cal. The Census Bureau will have data on 2014 total insurance coverage in September 2015.

Health Reform in California: A State of Accelerating Change

Gail Fulbeck and her husband paid $2,500 a month for health insurance in 2013. This year, they signed up for a Covered California plan and pay $165. (Lauren Whaley/Center for Health Reporting)

Gail Fulbeck and her husband paid $2,500 a month for health insurance in 2013. This year, they signed up for a Covered California plan and pay $165. (Lauren Whaley/Center for Health Reporting)

By Deborah Schoch and Lauren M. Whaley, CHCF Center for Health Reporting

Gail Fulbeck, 64, relies on her body for work. She hauls soda, energy drinks, snacks and water to the 23 vending machines she owns around downtown Sacramento.

The physical demands of her job, coupled with her husband’s history of migraines and bad knees, make health insurance essential.

Last year, Fulbeck and her husband paid a monthly insurance premium of $2,555.

Starting Jan. 1 of this year, the couple’s premium for a nearly identical plan totaled $165. It was, she said, almost unbelievable. Continue reading

Senator to Reintroduce Health Insurance Bill for Undocumented Immigrants

(Justin Sullivan/Getty Images)

(Justin Sullivan/Getty Images)

It’s the beginning of the new legislative session in Sacramento, and one lawmaker isn’t wasting time. Sen. Ricardo Lara (D-Long Beach) is expected to reintroduce a bill Monday to extend health insurance to all undocumented immigrants.

The Health For All Act would do two things for undocumented immigrants: extend Medi-Cal coverage to those who are low income and create a new marketplace to mirror Covered California, where those with incomes 138-400 percent of poverty could purchase subsidized health insurance.

Undocumented immigrants are not eligible for any Obamacare benefits, so they cannot use the existing Covered California exchange. Continue reading

Newly Protected Immigrants Will Be Eligible for Medi-Cal, Advocates Say

President Barack Obama announces executive actions on U.S. immigration policy Thursday. ( Jim Bourg-Pool/Getty Images)

President Barack Obama announces executive actions on U.S. immigration policy Thursday. ( Jim Bourg-Pool/Getty Images)

California undocumented immigrants who are eligible for deferred deportation under President Obama’s executive action are expected to be eligible for Medi-Cal, as long as they meet income guidelines, advocates said Thursday.

Medi-Cal is the state’s health insurance program for people who are low income.

Under federal law, these immigrants are not eligible for other benefits of the Affordable Care Act, including subsidies on the Covered California exchange. Continue reading

Spike in ER, Hospitalization Use Short-Lived After Medicaid Expansion

(Getty Images)

(Getty Images)

While the Medicaid expansion may lead to a dramatic rise in emergency room use and hospitalizations for many of the previously uninsured, that increase is largely temporary and should not lead to a dramatic impact on state budgets, according to a new analysis from the UCLA Center for Health Policy Research released Wednesday.

Researchers reviewed two years of claims data from nearly 200,000 Californians who had enrolled in public programs in advance of the expansion of Medi-Cal, the state’s version of Medicaid, in January. These programs were designed to ease the expansion of Medicaid by providing insurance to low-income adults who were not eligible for Medi-Cal at that point but would be when the health law’s expansion went into effect earlier this year.

Researchers then divided the group into four categories, based on the researchers’ assessment of each group’s pent-up demand for health care.

In July, 2011, after being enrolled in California’s Low Income Health Program, the so-called “bridge to reform,” the group with the highest pent-up demand had a rate of costly emergency room visits triple — or more — that of the other groups. But from 2011 to 2013, that high rate dropped by more than two-thirds and has remained “relatively constant,” according to the analysis. Continue reading

Medi-Cal Backlog Will Be ‘Down Significantly’ in Six Weeks

(Getty Images)

(Getty Images)

By David Gorn, California Healthline

At an Assembly Committee on Health hearing yesterday, Department of Health Care Services Director Toby Douglas said the backlog of Medi-Cal applications — at one point in March topping 900,000 unprocessed eligibility claims — now is down to about 250,000 applications and will be “down significantly” from that by the start of November.

Douglas answered a number of concerns at the hearing, including announcing a shift in DHCS policy regarding asthma and allergy testing, as well as Denti-Cal and special-needs dental care issues.

The counties and DHCS, Douglas said, reduced the Medi-Cal application backlog by 650,000 over six months — more than 100,000 a month. A similar pace in the next month-and-a-half would get it down to about 100,000 applications. Continue reading

Video: Why the New Autism Benefit Is So Important to Medi-Cal Families

Effective this week, Medi-Cal now covers a key autism therapy, and some 12,000 kids stand to benefit statewide. One of the children who will benefit is Timothy Wilson, a bubbly 6-year-old who will now be able to get Applied Behavior Analysis (ABA) through Medi-Cal, the state’s insurance program for people who are low income. ABA is the clinical standard of care for autism.

Timothy was 2 when he was diagnosed with autism spectrum disorder. “He didn’t say mama, didn’t say dada,” says his mother, Jazzmon Wilson. He threw tantrums and hardly made eye contact. “You just see all your dreams go by the wayside.”

The Wilsons enrolled him in the Regional Center of the East Bay, where children under 3 receive state-funded services. He began ABA therapy, which breaks down everyday skills into bite-sized, learnable portions, then uses repetition, memorization and rewards to reinforce or discourage behaviors. Parents learn to lead their child in the therapy as well. In the video, Jazzmon works with Timothy — or Bubba as she calls him. Seeing him now, it’s hard to believe how affected he was at a younger age. Continue reading

Advocacy Groups File Lawsuit Over Medi-Cal Backlog

(s_falkow: Flickr)

(s_falkow: Flickr)

By Anna Gorman, Kaiser Health News

California’s lingering backlog of Medi-Cal applications has left hundreds of thousands of people unable to access the health care they are entitled to receive, according to a lawsuit filed Wednesday by a coalition of health advocates and legal services groups.

A Tulare County man had applied for Medi-Cal but died of a pulmonary embolism while waiting for the state to confirm his eligibility.

The lawsuit, filed in Alameda County Superior Court, says the state is failing to process applications within 45 days as required by law. Some applicants have been waiting to receive their Medi-Cal cards since the end of last year, according to the suit. The applicants include children, pregnant women and adults with life-threatening health conditions, who advocates say are either postponing treatment or paying cash to see doctors.

Medi-Cal is the state’s version of Medicaid, the publicly funded health insurance program for low-income Americans. About 11 million people receive Medi-Cal benefits in California, including 2.2 million who applied since January. Roughly 350,000 applications are still pending. Continue reading

Autism Benefit Finally a Reality for Children on Medi-Cal

Jazzmon Wilson with her son Timothy, 6, who has autism. (Jeremy Raff/KQED)

Jazzmon Wilson with her son Timothy, 6, who has autism and has benefited greatly, Wilson says, from Applied Behavior Analysis therapy, now covered by Medi-Cal. (Jeremy Raff/KQED)

By David Gorn

California health officials Monday are launching a new benefit for thousands of children with autism who are covered by Medi-Cal, California’s low-income health program.

“He’s doing things other kids can do. And it’s those little moments, it makes you just so grateful.”

That makes California the first state in the nation to implement new federal standards on autism care.

The new benefit includes coverage of the clinical standard of care for autism treatment — Applied Behavior Analysis, also known as ABA therapy. That treatment has shown significant results for a cross-section of children with autism.

Of the 5 million children on Medi-Cal in California — that’s roughly half the state’s total children — there are an estimated 75,000  who likely have autism spectrum disorder. Of those children, experts expect about 12,000 children to access the new benefit, based on utilization figures from programs in other states. Continue reading