Review of California MediCal enrollees’ eligibility under way

SAN FRANCISCO – MediCal enrollees in California are strongly encouraged to update their information to keep their status as the state reviews eligibility for the first time since the Covid 19 pandemic.

The advisory is being widely disseminated urgently as California has 14 months to review the eligibility of 15 million Medi-Cal enrollees as of April 2023 as an estimated two to three million Californians may have to leave the program during this “unwinding period” that is happening nationwide.

The information campaign comes as for the first time in three years, an estimated 80 million Americans across the country whose health care is through Medicaid will have their eligibility for it checked.

Suspension of the redetermination process became important step of the 2020’s Families First Coronavirus Response Act that required Medicaid programs nationwide to keep everyone enrolled during the COVID-19 public health emergency. But since emergency is now considered over as of March 31, states have to confirm everyone’s eligibility again.

Enrollees are strongly asked to watch out for notifications from their local Medi-Cal offices particularly if they are sent yellow envelopes as they need to provide more information and must respond right away to keep their coverage or ran the risk of getting disenrolled if they do not respond or because of administrative barriers, such as local Medi-Cal offices not having their current contact information.

At a joint Ethnic Media Services/California Black Media news briefing, in partnership with the California Department of Health Care Services, speakers broke down the steps involved in the redetermination process, who is at risk for being disenrolled, what people can do to get ready, and how to get information in 19 languages on the DHCS website.

California’s Medicaid program, MediCal, is the country’s largest, serving about 15 million people – including 5.7 million children, 70% of them nonwhite. Over the next 14 months, the state will be reviewing accounts to make sure contact information is up to date and that everyone enrolled is still eligible.

Assistant Deputy Director of California Department of Health Care Services (DHCS) Yingjia Huang impressed upon the need for updated information from MediCal members to update their addresses, their phone numbers, and their email addresses and the easiest way to do this is online.

“Not everyone will be redetermined at the same time. All our members will actually have different medical renewal months. And so depending on the renewal month, they may potentially get auto renewed and they will get a letter in the mail from their local medical county office stating “congratulations, your medical has been renewed for one year,” Huang stated. “Or if they are not renewed automatically, what’s going to happen is the local MediCal office will need to send out a packet in the mail and the packet will come in a yellow envelope.”

Huang added that it is critical that packets are returned by the due date as there is a possibility that one will lose coverage from MediCal if that’s not completed by the due date.

“If you are not eligible for MediCal, because you may have made more money over the course of the pandemic, the county will automatically send your information to Covered California, which is the state’s exchange for you to purchase insurance with a premium tax credit. That process is automatic. Covered California will automatically take your case and they will review all the income, making sure your information is accurate, and to connect you to a plan for you to choose and make a plan and plan selection,” assured Huang.

Children’s Partnership Executive Director Mayra Alvarez shared that her organization continues to serve because of the need to help families keep their coverage, keep their children’s, keep their own MediCal coverage as access to care is essential for everyone to be healthy and to thrive, particularly during this pandemic, which has also exacerbated mental health issues for children and youth across the state.

“Over half of all of our kids in California depend on MediCal. Overwhelmingly, the people that are enrolled in MediCal are people of color. In fact, almost 70% of children enrolled in MediCal are children of color. It is a lifeline for so many in our communities, and it’s a program that continues to be available for the millions enrolled,” Alvarez underscored.

Alvarez lamented that multiple analyses at the federal level that have found children are more likely to lose coverage because of procedural issues and administrative barriers, not because they’re no longer eligible. Aside from changes in contact information, another thing to take into consideration is if there are new members of the family who hadn’t been born at the time of the last eligibility check, or if you’ve assumed new caretaking responsibilities.

Sadly, however, that with the redetermination process it is estimated that 2.3 million MediCal beneficiaries may lose their MediCal coverage that may translate to 800,000 to 1 million children losing their MediCal coverage.

“Nevertheless, as we continue to strengthened MediCal for our family, last year the State of California did enact the policy to cover young kids in MediCal continuously. That policy is slated to begin in 2025 and we are initiating to have this moved this policy as early as possible,” Alvarez said.

On a brighter note, Alvarez announced that they are gearing up to expand the MediCal coverage to undocumented community when in January 2024 when 26-49 year olds will be newly eligible to MediCal in California, the first state in the country to allow all eligible undocumented people to be a part of MediCal.

Towards this end, Huang chimed, “On the MediCal application, there is an option for no SSN. You don’t have to select an immigration status. That is no longer needed with eligibility expansion happening in the State of California. The counties are trained and systems are programmed to understand those responses and confer medical eligibility as such. It is no longer needed for eligibility.”

“You don’t have to indicate your citizenship status when applying for MediCal and undocumented Californians also need not worry that using Medi-Cal will impact their applications for a green card under “public charge” rules, a widespread, long-standing fear,” Alvarez emphasized in this expansion of coverage process. “New rules in late 2022 barred any past, current or future use of public safety net protections, such as Medicaid, but also including housing, food and tax credits, from being deemed a “public charge,” and jeopardizing immigration applications. Nor does signing up your child for benefits count against you.”

California Department of Health Care Services Associate Governmental Program Analyst Maria Romero Mora echoed optimism on support for eligibility determination of MediCal members and advised them to contact their county DHCS offices for their plans and learn to navigate that system if they don’t know how to do it.

“And there’s a lot of support online. The Navigators are supporting families hand in hand to walk them through that process. The local offices are there to receive those calls or in person with the eligibility piece to make sure that that individual doesn’t lose their coverage,” Mora implores members. “Anybody, regardless of their immigration status, regardless of their income, can apply for MediCal. I started working with children that were undocumented to enroll them into emergency medical in a local health plan. That was 15 years ago, and we’re in a much better position.(Jun Nucum)