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

Medi-Cal Enrollment Surging Via Covered California

(David McNew/Getty Images)

(David McNew/Getty Images)

David Gorn, California Healthline

The Department of Health Care Services released enrollment numbers last week for Medi-Cal-eligible Californians who initially contacted the Covered California health benefit exchange.

The department said 143,608 people will likely receive Medi-Cal coverage as a result of contacting Covered California.

That’s about 40 percent of all applications completed through the exchange, said Anthony Cava, a spokesperson for DHCS.

“We are very pleased with this surge of interest and the momentum we are seeing in consumer awareness,” Cava said in a written statement. Continue reading

California Sends Incorrect Information to 246,000 Low-Income Patients


By Anna Gorman, Kaiser Health News

California has mistakenly sent letters to 246,000 low-income residents, warning they may need to find new doctors next year under the state’s newly expanded Medicaid program.

The error frustrated counties and community health centers which have repeatedly assured patients they can keep their providers when the Affordable Care Act takes effect in 2014. The patients are part of the state’s “bridge to reform” program, which was designed to cover uninsured, poor Californians until they became eligible for Medi-Cal, the state’s version of Medicaid.

Bridge to reform launched in 2011 and more than 600,000 people across the state enrolled in county-based health coverage. Many people formed relationships with doctors and started seeking regular care. But county and clinic administrators said the incorrect information in the mailing this month has put the counties’ efforts in jeopardy.

The mix-up occurred as people are scrambling to figure out how the health law impacts them, and as private policy holders have been receiving letters canceling their insurance plans. Continue reading

For This Uninsured Man, Medicaid Looks Good

Brad Stevens used to think he didn’t need health insurance. (Sarah Varney/Kaiser Health News)

Brad Stevens used to think he didn’t need health insurance. (Sarah Varney/Kaiser Health News)

By Sarah Varney, for Kaiser Health News and NPR

Have you heard about the young invincibles? That’s the name given to young people who think nothing bad can happen to them.

Enrollment of healthy people like them in insurance under the Affordable Care Act is key to offsetting the costs of older, less healthy buyers.

Brad Stevens is 54-years-old and not so invincible anymore. He has been uninsured for most of his adult life — “ever since about 24 when I finished college,” he says. “Basically, I’ve always tried to take care of myself and be healthy and exercise and eat right and take vitamins and that type of thing.”

During the three decades Stevens has spent without health coverage, there have been numerous attempts to curb the ranks of the uninsured in the U.S. Now, the Affordable Care Act is changing the nation’s insurance market.

Stevens, who lives in Lakeport, on the west shore of northern California’s Clear Lake, has plenty of company. Twenty percent of California’s population is uninsured; some 5 million people could gain coverage under the health law.

The Kaiser Family Foundation surveyed 2,000 of California’s uninsured on the eve of the opening of health care exchanges across the country. Stevens took part in the survey, which aims to follow the same people over the next two years. (Kaiser Health News is an editorially independent program of the Kaiser Family Foundation.)

Over the years, Stevens wasn’t interested in the debate over how best to provide health care to the uninsured. He didn’t view it as an issue for him. “I’m the epitome of health, and so I didn’t have much concern. My health care was working out every day, eating right and taking care of myself,” he says. Continue reading

3 Out of 4 Uninsured Californians Eligible, But Unaware of Obamacare Benefits

(Getty Images)

(Getty Images)

By Sarah Varney, Kaiser Health News

As uninsured Californians head into a new era of health coverage, they’re worried about costs and unaware of the help they’ll get from the government, a new survey finds.

The survey, by the Kaiser Family Foundation, found that three out of four Californians who earn modest incomes and could buy government-subsidized private coverage wrongly believe they’re not eligible for federal assistance or simply don’t know if they qualify.

In addition, many undocumented immigrants, who constitute about a fifth of the state’s uninsured population, erroneously believe they will be eligible for coverage. The law specifically bars them from getting coverage from the state’s new health insurance marketplace, which opens next Tuesday, for coverage beginning Jan.1, 2014.

“This has been, for so long, a political debate,” said Anthony Wright, executive director of Health Access, a Sacramento-based consumer advocacy group. “We’re just starting to move it into a practical reality. Now that the benefits are close at hand, there is a concerted effort to educate people about what their benefits are.” Continue reading

With Lax Oversight, Fraud Flourishes in California’s Drug Rehab Clinics

A receptionist at Pride Health Services in Inglewood, Calif., said there were no counseling sessions on April 3. But the clinic billed taxpayers about $1,600 for serving 60 clients that day, records show. (Photo/CNN)

A receptionist at Pride Health Services in Inglewood, Calif., said there were no counseling sessions on April 3. But the clinic billed taxpayers about $1,600 for serving 60 clients that day, records show. (Photo/CNN)

By Christina Jewett and Will EvansThe Center for Investigative Reporting

Addiction counselor Tamara Askew discovered something wrong soon after she started working at Pride Health Services, an Inglewood rehab clinic.

Askew grabbed a stack of files and began contacting patients to introduce herself. That was harder than she had figured.

Some were in jail, Askew said. Several never showed up. One was dead.

Her boss, she said, wanted to bill the government anyway, for counseling addicts she never saw.

“He basically said, ‘How do you think you’re going to get paid?’ ” Askew said.

They lure patients in from the street by handing out cash, cigarettes and snacks. They have patients sign in for days they aren’t there.
Pride Health Services specializes in billing for “ghost clients,” fabricating paperwork for patients who don’t actually come in, according to former employees and whistle-blower complaints.

It is part of a rehab racket – a pattern of fraud by rehabilitation clinics that collect government funding to help the poor and addicted, a yearlong investigation by The Center for Investigative Reporting and CNN has found.

Thousands of pages of government records and dozens of interviews with counselors, patients and regulators reveal a widespread scheme – concentrated in the Los Angeles region – to bilk the state’s Medicaid system. Continue reading

Medi-Cal and Obamacare: Some Surprising Twists

Editor’s Note: This post is part of a regular column from Emily Bazar with the CHCF Center for Health Reporting. Bazar answers consumers’ questions about Obamacare. 

Q: If my family of six qualifies for Medi-Cal under the Affordable Care Act, do we have to sign up for that? Or can we still buy subsidized health care plans through Covered California? … I have real concerns about the quality of care we would get on Medi-Cal. I’m hoping for a positive answer!

A: Sadly, I’m about to disappoint Beth from Modesto and others in her situation.

Medi-Cal is the state’s publicly funded health program for low-income and disabled residents, and currently provides care to more than 8 million Californians. (It is the state’s version of the federal Medicaid program.)

(Getty Images)

(Getty Images)

Starting in January, Medi-Cal will broaden its eligibility requirements as a result of Obamacare, allowing applicants with higher incomes and those who were previously ineligible, such as childless adults, to get coverage.

But whether you’re eligible for Medi-Cal now or become eligible then, that fact alone disqualifies you from tax subsidies on the health insurance marketplace, which is called Covered California.

Covered California will offer 13 health plans across the state (not all in each region) that cover a standard set of benefits. Individuals and families who earn between 138 percent and 400 percent of the federal poverty level will be eligible for sliding-scale tax credits to purchase those plans. Continue reading

Thousands Expected for Rally to Block Medi-Cal Rate Cuts

By David Gorn, California Healthline


Protesters are calling on the governor to restore $1 billion in health care funding. (seliaymiwell/flickr)

Thousands of doctors, dentists, patients, health care professionals and other protesters are expected to gather Tuesday outside the Capitol Building to support the idea of reversing a 10 percent Medi-Cal provider rate cut. Organizers say it will be the largest health care protest in Sacramento history.

“We have people hopping on buses in Oceanside at 4 in the morning to get here,” said Molly Weedn, director of media relations for the California Medical Association. “People are coming from all over the state, and we’ve seen support from both sides in the Legislature. All of this [support] shows that the public doesn’t want Medi-Cal to be cut, so that’s why we’re doing this.”

It has been a tough couple of weeks for proponents of reversing the rate cut made in 2011 and not yet implemented because of court battles.

On May 24, the Ninth Circuit federal appeals court ruled the Medi-Cal cut to be legal, and lifted the injunctions on its implementation. That means the lawsuits to reverse the reduction now have only legal recourse, and that’s an appeal to the U.S. Supreme Court. Continue reading

Appeal Denied: Medi-Cal Rate Cuts Poised to Move Forward

By Judy Lin, Associated Press

A federal appeals court on Friday denied a second request by California doctors, pharmacists and hospitals seeking to undo the state’s 10 percent provider rate cut for treating the poor.

The 9th U.S. Circuit Court of Appeals denied an appeal from medical providers to rehear their case, which allows Gov. Jerry Brown to begin implementing the cuts retroactively. A three-judge panel had ruled against them in December on the grounds that trial courts cannot block the state from making cuts that were approved by the U.S. Department of Health and Human Services.

Health providers vowed they will continue to press lawmakers to restore the 10 percent reimbursement rate cut to the state’s Medicaid program, known as Medi-Cal. Continue reading