Medi-Cal

RECENT POSTS

Another Step Closer to Autism Therapy as Medi-Cal Benefit?

(Getty Images)

(Getty Images)

By David Gorn, California Healthline

CMS officials last week approved a state plan amendment for the state of Washington that includes autism therapy as a Medicaid benefit.

It’s the second state in a month to receive that go-ahead from the federal government, and it means autism coverage should be a Medi-Cal benefit in California, as well, according to Kristin Jacobson, president of Autism Deserves Equal Coverage, a not-for-profit autism advocacy group.

The budget passed this week by the California Legislature omitted autism therapy as a Medi-Cal benefit.

Autism advocates hope one day soon CMS will make it clear that applied behavior analysis treatment — known as ABA therapy — should be a required benefit for all states receiving Medicaid, including California. Continue reading

In Alameda County, Leaving Jail Doesn’t Have to Mean Losing Health Care

Rodrigo Salido, recently released from Santa Rita jail in Dublin, Calif., enrolls in Medi-Cal at Healthy Oakland clinic. (Courtesy: PBS NewsHour)

Rodrigo Salido, recently released from Santa Rita jail in Dublin, Calif., enrolls in Medi-Cal at Healthy Oakland clinic. (Courtesy: PBS NewsHour)

By Sarah Varney, Kaiser Health News and PBS NewsHour

It’s been two months since Rodrigo Salido left the maximum security wing at Santa Rita jail, about 40 miles east of San Francisco in Alameda County. It’s also been two months since Salido had medication for his bipolar disorder.

In Alameda County officials estimate 18,000 offenders in its two jails will now qualify for Medi-Cal.
A drug, Risperdal, prescribed by a jailhouse psychiatrist, had quelled Salido’s angry moods. “It helped me be more relaxed,” he said. “Not as much on the edge and feeling like everybody is out to get me.”

Now Salido, who served two years for burglary, assault and gang involvement, has no health insurance and until recently had few options for refilling his medication.

Many inmates leave county jails and state prisons with mental health problems and chronic physical ailments — and no health coverage. Because they typically are not custodial parents, ex-offenders have long been ineligible for a public health insurance program aimed at kids, mothers and the disabled. Continue reading

SEIU Teams Up with California Hospitals, Withdraws Ballot Initiatives

(Getty Images)

(Getty Images)

The California Hospital Association and Service Employees International Union say they have reached a “unique agreement” that will “change the face of healthcare in California.”

And in the process, the two ballot initiatives SEIU backed — that would have put dramatic limits on both hospital charges and CEO compensation — are being withdrawn.

The partnership was announced Tuesday morning, is effective immediately, and runs through December 31, 2017. In a long call with reporters, both sides emphasized what they called the centerpiece of the deal: a $100 million “joint advocacy fund.” Continue reading

Obamacare in Jail: How San Francisco Policy Helps Inmates

A new law permits San Francisco Sheriff Department staff to enroll people into health plans. (Thomas Hawk/Flickr)

A new law permits San Francisco Sheriff Department staff to enroll people into health plans. (Thomas Hawk/Flickr)

The San Francisco Sheriff’s Department is implementing a new city law allowing its staff to enroll inmates into health insurance under the Affordable Care Act. Sheriff Ross Mirkarimi believes that making sure people have health coverage when they’re released will help prevent them from committing another crime and coming back.

“I believe that will go a long way to helping us improve public safety by using a public health strategy,” he said.

Health insurance sign-ups available to all inmates at the San Francisco county jail.

He estimates this will help save taxpayers millions of dollars.

One inmate – Sophia – recently requested help signing up for health insurance. Sophia, who asked that her last name not be used, was caught driving a stolen car in January and sentenced to three months in the county jail. She says that was because she stopped getting treatment for her substance abuse and mental health problems when her health insurance expired. Continue reading

Waiting For Medi-Cal To Kick In

Teresa Martinez, 62, works as a hairdresser at a Koreatown hair salon. She earns about $10,000 per year and cannot afford to buy private health coverage (Photo by Heidi de Marco/KHN).

Teresa Martinez, 62, works as a hairdresser at a Koreatown hair salon. She earns about $10,000 per year and cannot afford to buy private health coverage (Photo by Heidi de Marco/KHN).

by Anna Gorman, KHN

For most of Teresa Martinez’s life, buying health insurance has been out of the question. She works at a Koreatown hair salon, earning about $10 per cut – not nearly enough to afford private coverage.

With a long list of ailments including dizziness, blurry vision and leg pain, she eagerly applied last year for a county program that would cover her for free until Obamacare set in.

“I thought at long last, I would be able to go to the doctor and get what I need,” said Martinez, 62, who lives in East Los Angeles. “I was so excited. But that was short lived.”

The state has 45 days to process the Medi-Cal applications but it often takes longer and the waiting period varies — sometimes widely — by county.

Without any explanation, Martinez received a denial letter from the Healthy Way Los Angeles, a temporary coverage program for low-income people. Later she applied for Medicaid — known as Medi-Cal in California — which was expanded under the Affordable Care Act to include people like Martinez without dependent children.

But a health clinic worker told her she may have to wait months for approval — and to hold off on appointments until she has her official card.

Nearly 2 million Californians have gained coverage with the expansion of the Medi-Cal program for poor and disabled people, including those who transitioned from temporary programs like Healthy Way LA. Continue reading

New Bill Would Extend Health Coverage to Undocumented Immigrants

(Getty Images)

(Getty Images)

Anna Gorman, Kaiser Health News

In a push to cover immigrants excluded from the nation’s health reform law, a California state senator has proposed legislation that would offer health insurance for all Californians, including those living here illegally.

The bill, SB 1005, would extend state-funded Medi-Cal to low-income immigrants who, because they are in the country without permission, are now eligible only for emergency and pregnancy coverage. It would also create a marketplace similar to Covered California to offer insurance policies to higher income immigrants who lack legal status.

It’s not clear how much the new coverage would cost or how the state would fund it.

Sen. Ricardo Lara, a Democrat who represents Long Beach and southeast Los Angeles, announced the proposed legislation at a press conference Friday. He said immigrants contribute to the California economy and deserve to have access to health insurance. Continue reading

New Health Plan for the Poor and Elderly Raises Questions

Christina Kahn, manager of the San Mateo Health Insurance Counseling and Advocacy Program, returns phone calls to local seniors.

Christina Kahn, manager of the San Mateo Health Insurance Counseling and Advocacy Program, returns phone calls to local seniors. (April Dembosky/KQED)

A new experiment in managing the health of older Californians is causing a lot of confusion among seniors. Letters have been hitting mailboxes around the state this week with information about the changes. It’s the second letter in a series of three — the first went out in January — and they have been inspiring a lot of calls to county health insurance counseling centers.

“Why do they keep doing this to us old people?” asks a woman named Andrea, a 72-year-old resident of San Carlos. She called San Mateo County’s counseling office when she received her first letter, telling her she was going to be automatically enrolled in a new health plan — one she’d never heard of and never intended to sign up for.

“We get used to one thing and now we have to do something else?” she said. “I’ve gotta call quick. Otherwise I’ll get something, and maybe I don’t want that.”

Christina Kahn, manager of the Health Insurance Counseling and Advocacy Program of San Mateo County, has been returning phone calls like Andrea’s to explain. Continue reading

Medi-Cal Expansion Opens Doors to Care for Transgender Patients

Darryl Avery is a transgender man seeking medical care to complete his transition. (Angela Hart/KQED)

Darryl Avery is a transgender man seeking medical care to complete his transition. (Angela Hart/KQED)

By Angela Hart

Among those estimated to enroll in the expansion of Medi-Cal, some of those most likely to benefit are among the most stigmatized in health care — transgender patients. Darryl Avery, 48, is one of them. Avery was born female, but identifies as a man. Several years ago, he began his transition. He moved to San Francisco where he sought medical care, stable housing, culinary schooling, and eventually, sex reassignment surgery.

“I’ve seen so many trans people with mental health problems, they get access to treatment, and it’s like you’ve flipped a light switch on.” 
“Where I grew up in New Jersey, there were no resources for me,” Avery said. “I never had anyone I could relate to until I moved here. I was no longer called a freak.”

Avery lives without a steady source of income. Because California is expanding its Medicaid program, known as Medi-Cal here, Avery now has access to health insurance. More than one million Californians are newly enrolled as of January 1.

And for people like Avery, who are seeking transgender care and sex-reassignment surgery, it’s a “big deal” says Dawn Harbatkin, Avery’s primary care physician who is also executive director for Lyon Martin Health Services, an LGBT-focused community health clinic on Market Street near San Francisco’s Hayes Valley neighborhood.

Continue reading

Signing up the Homeless, One at a Time

Man sits in Skid Row area of Los Angeles. Advocates say homeless people tend to have complex health problems. (Kevork Djansezian/Getty Images)

Man sits in Skid Row area of Los Angeles. Advocates say homeless people tend to have complex health problems. (Kevork Djansezian/Getty Images)

By Anna Gorman, Kaiser Health News

On a recent winter morning, health outreach worker Christopher Mack walked through the streets and alleys of the city’s Skid Row, passing a man pulling a rusty shopping cart and a woman asleep on a crumpled blue tarp. The smell of marijuana wafted through the cold air.

“Do you have health insurance?” Mack, a towering man with long dreadlocks, asked one woman. “Do you go to the doctor?” he asked another.

Homeless men and women who didn’t qualify for insurance in the past now have the chance to sign up, and Mack — who was once homeless himself — is there to help.

The Affordable Care Act allows states to expand Medicaid to include poor people without children or disabilities who haven’t been able to get the free insurance in the past. Experts say determining how many homeless people are eligible for Medicaid is difficult but estimates range from about 500,000 to as many as 1.2 million. California is one of the 25 states (plus Washington, D.C.) that is expanding its Medicaid program, called Medi-Cal here. Continue reading

Obamacare FAQ: When Can You Buy or Switch Insurance?

(Getty Images)

(Getty Images)

Editor’s note: For people buying on the individual market who want health insurance starting Jan. 1, the deadline to sign up is Monday, Dec. 23. We are running one post a day with questions and answers on the Affordable Care Act and Covered California until that deadline. Readers can also consult KQED’s Obamacare Guide, written specifically for Californians.

By Emily BazarCHCF Center for Health Reporting

Q: Our 24-year-old daughter is employed full-time and her employer offers health insurance. Does she have to enroll in one of their plans or can she stay on ours until her 26th birthday?

A: Young adults and college students will have more insurance options in the new health care landscape than just about any other group, including both the Covered California marketplace and Medi-Cal, depending on their income.

Gwen from San Jose wants to know more about one option, a popular Obamacare provision that already allows parents to keep their young-adult children on their policies until their kids turn 26.

The good news, Gwen, is that your daughter can stay on your employer-sponsored plan until she’s 26, but … (And there is always a “but” … ) Continue reading