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After a Pandemic Pause, the State Will Restart Checking Medi-Cal Eligibility

California will soon restart its annual eligibility review for people enrolled in Medi-Cal, a process that has been suspended since the onset of the COVID-19 pandemic. This means that starting in mid-April, residents enrolled in Medi-Cal, the state’s insurance program for low-income people, will start to receive renewal notices in the mail. The process will be spread over 14 months.

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State officials estimate that between 2 million and 3 million people could lose their Medi-Cal coverage.
State officials estimate that between 2 million and 3 million people could lose their Medi-Cal coverage.

By Ana B. Ibarra
CalMatters

California will soon restart its annual eligibility review for people enrolled in Medi-Cal, a process that has been suspended since the onset of the COVID-19 pandemic.

This means that starting in mid-April, residents enrolled in Medi-Cal, the state’s insurance program for low-income people, will start to receive renewal notices in the mail. The process will be spread over 14 months. Some people may be automatically re-enrolled, but most people will have to fill out a renewal packet with information about their income and household size. People who no longer qualify or who fail to fill out the paperwork will lose their free or low-cost coverage.

State officials estimate that between 2 million and 3 million people could lose their Medi-Cal coverage. Ideally, people who no longer qualify for Medi-Cal will transition to a plan in the state’s insurance marketplace, Covered California, or to a job-sponsored health plan. Still, health advocates worry that many people could fall through the cracks or get caught in administrative hurdles and become uninsured, leaving them more likely to delay or forgo care altogether.

Currently, 15.4 million people — more than a third of the state’s population — are enrolled in Medi-Cal, the most ever, according to the California Department of Health Care Services. That’s partly a result of the increased need during the pandemic: As people lost jobs and wages, many also lost their medical insurance. From March 2020 to February 2023, Medi-Cal enrollment increased 16%, according to the department.

And as thousands of people became newly eligible for Medi-Cal, far fewer were coming off. Federal rules prohibited states from dropping people from government-sponsored insurance during the pandemic as a way to protect access to care. Now those federal rules are lapsing.

California’s renewal process will restart on April 1 and should be completed around June 2024, meaning people can receive their renewal notices and paperwork anytime during this time period. Those who in the past have renewed in the month of June will get their paperwork first, said Yingjia Huang, assistant deputy director for health care benefits and eligibility at the Department of Health Care Services. This phased-in approach will help spread the caseload for county offices in charge of the review, Huang said, and also allow enrollees who have renewed in the past to keep a similar timeline.

To qualify for Medi-Cal, people can earn up to 138% of the federal poverty level — that’s $20,121 a year for an individual or $41,400 for a family of four. Some Californians, such as pregnant women and people with disabilities, may qualify with slightly higher incomes.

People who were eligible for Medi-Cal at some point during the pandemic, but who may no longer qualify because their income has increased, will be automatically transitioned into a similar plan through Covered California, Huang said.

“The system automatically will review their eligibility for Covered California and Covered California will send out the enrollment notice to the member, informing them of their options and to pay the plan premium. So there’s no administrative burden on a member,” Huang said. “We’re trying to make sure that process is seamless and streamlined.”

Whether people successfully make the switch will largely depend on their ability to pay their new monthly premium.

Most people who buy from the marketplace receive generous subsidies, and some people don’t have a premium cost at all. Nearly half of the people enrolled in coverage through Covered California pay less than $50 a month, according to the agency. Still, even a $5 premium, along with the accompanying deductibles and copays, can discourage people from buying a health plan, said John Baackes, CEO of L.A Care, which offers Medi-Cal and Covered California plans to Los Angeles residents.

This auto-transition into Covered California will be a new test for the state. In the past, when people disenrolled from Medi-Cal, they were likely to go without coverage at least temporarily. Between 2016 and 2019, roughly 65% of people who dropped off Medi-Cal (Medicaid in other states) had a period of uninsurance, according to national research from the Kaiser Family Foundation.

To help avoid unnecessary loss in coverage, state officials are asking enrollees to verify   their contact information. The Department of Health Care Services estimates that about 12% of enrollees may have moved during the pandemic and are at risk of not receiving their renewal packets. People who have moved during the pandemic should update their address via the state’s KeepMediCalCoverage.org website or by contacting their local county office.

Health advocates are concerned that people won’t be able to access timely help, given the influx of calls and visits county offices may receive. The increased volumes compounded by workforce shortages can prove to be a barrier, said Tiffany Huyenh-Cho, a senior staff attorney with Justice in Aging, a legal aid organization that advocates on behalf of seniors.

“We need these county offices to be appropriately staffed because that is the first place people go with a question about eligibility,” Huyenh-Cho said. “We already hear reports of long wait times in general.”

Awareness that the renewal process is restarting is also key, advocates say. State and county officials have known that the Medi-Cal renewal process would restart at some point, even though the timeline was pushed back multiple times. The general public may be less aware. One national survey found that as of December, 64% of enrollees had not heard of the return to regular eligibility checks, though education efforts have been ramping up as the April 1 date gets closer.

“I wonder how many of these 15 million people even know they still have Medi-Cal coverage?” said Shannon McConville, a research fellow at the Public Policy Institute of California, noting that many people, especially if healthy, distanced themselves from routine care during the pandemic.

Baackes at L.A. Care said the onus of spreading the word about the renewal period also falls on the health insurance plans. L.A. Care, he said, has been beefing up its staff to prepare for the anticipated volume of calls and requests. It will also have 14 locations where people can go and get help filling out the hefty packet.

“The packet is 20 pages. It should be one page: ‘Where do you live? How much do you make? Thank you,’ but it’s 20 pages. So one of the things we’ll be doing is we’ll have these community resource centers spread across the county,” Baackes said.

Among his concerns is that the Medi-Cal renewal process will be taking place at a time  when California is preparing for some key expansions and changes. Starting in 2024, more people will qualify for full-scope Medi-Cal benefits as the state opens enrollment to income-eligible undocumented people ages 26 to 49, the last remaining age group. About 700,000 people are expected to gain benefits through that expansion.

At the same time, the state will also commence new Medi-Cal contracts with insurers, which could result in health plan changes for some enrollees. That’s a separate process, Huang at the state department said, and will not require any action from enrollees.

But these different moving parts happening at the same time will create more traffic in county social services offices, Baackes said.

“It’s just unfathomable to me,” he said, “that the state thinks that this is all going to happen without huge confusion on the part of the people we’re trying to serve.”

 

 

Copyright © 2023 Bay City News, Inc.  All rights reserved.  Republication, rebroadcast or redistribution without the express written consent of Bay City News, Inc. is prohibited. Bay City News is a 24/7 news service covering the greater Bay Area.

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AnaBIbarra/CalMatters2352p03/03/23

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Activism

Gov. Newsom Approves $170 Million to Fast Track Wildfire Resilience

AB 100 approves major investments in regional conservancies across the state, including over $30 million each for the Sierra Nevada, Santa Monica Mountains, State Coastal, and San Gabriel/Lower LA Rivers and Mountains conservancies. An additional $10 million will support wildfire response and resilience efforts.

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Courtesy of California Governor Gavin Newsom’s Facebook page.
Courtesy of California Governor Gavin Newsom’s Facebook page.

By Bo Tefu
California Black Media

With wildfire season approaching, last week Gov. Gavin Newsom signed Assembly Bill (AB) 100, unlocking $170 million to fast-track wildfire prevention and forest management projects — many of which directly protect communities of color, who are often hardest hit by climate-driven disasters.

“With this latest round of funding, we’re continuing to increase the speed and size of forest and vegetation management essential to protecting communities,” said Newsom when he announced the funding on April 14.

“We are leaving no stone unturned — including cutting red tape — in our mission to ensure our neighborhoods are protected from destructive wildfires,” he said.

AB 100 approves major investments in regional conservancies across the state, including over $30 million each for the Sierra Nevada, Santa Monica Mountains, State Coastal, and San Gabriel/Lower LA Rivers and Mountains conservancies. An additional $10 million will support wildfire response and resilience efforts.

Newsom also signed an executive order suspending certain regulations to allow urgent work to move forward faster.

This funding builds on California’s broader Wildfire and Forest Resilience Action Plan, a $2.7 billion effort to reduce fuel loads, increase prescribed burning, and harden communities. The state has also launched new dashboards to keep the public informed and hold agencies accountable.

California has also committed to continue investing $200 million annually through 2028 to expand this effort, ensuring long-term resilience, particularly in vulnerable communities.

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Activism

California Rideshare Drivers and Supporters Step Up Push to Unionize

Today in California, over 600,000 rideshare drivers want the ability to form or join unions for the sole purpose of collective bargaining or other mutual aid and protection. It’s a right, and recently at the State Capitol, a large number of people, including some rideshare drivers and others working in the gig economy, reaffirmed that they want to exercise it. 

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Shutterstock

By Antonio‌ ‌Ray‌ ‌Harvey‌
California‌ ‌Black‌ ‌Media‌

On July 5, 1935, President Franklin D. Roosevelt signed into federal law the National Labor Relations Act (NLRA). Also known as the “Wagner Act,” the law paved the way for employees to have “the right to self-organization, to form, join, or assist labor organizations,” and “to bargain collectively through representatives of their own choosing, according to the legislation’s language.

Today in California, over 600,000 rideshare drivers want the ability to form or join unions for the sole purpose of collective bargaining or other mutual aid and protection. It’s a right, and recently at the State Capitol, a large number of people, including some rideshare drivers and others working in the gig economy, reaffirmed that they want to exercise it.

On April 8, the rideshare drivers held a rally with lawmakers to garner support for Assembly Bill (AB) 1340, the “Transportation Network Company Drivers (TNC) Labor Relations Act.”

Authored by Assemblymembers Buffy Wicks (D-Oakland) and Marc Berman (D-Menlo Park), AB 1340 would allow drivers to create a union and negotiate contracts with industry leaders like Uber and Lyft.

“All work has dignity, and every worker deserves a voice — especially in these uncertain times,” Wicks said at the rally. “AB 1340 empowers drivers with the choice to join a union and negotiate for better wages, benefits, and protections. When workers stand together, they are one of the most powerful forces for justice in California.”

Wicks and Berman were joined by three members of the California Legislative Black Caucus (CLBC): Assemblymembers Tina McKinnor (D-Inglewood), Sade Elhawary (D-Los Angeles), and Isaac Bryan (D-Ladera Heights).

Yvonne Wheeler, president of the Los Angeles County Federation of Labor; April Verrett, President of Service Employees International Union (SEIU); Tia Orr, Executive Director of SEIU; and a host of others participated in the demonstration on the grounds of the state capitol.

“This is not a gig. This is your life. This is your job,” Bryan said at the rally. “When we organize and fight for our collective needs, it pulls from the people who have so much that they don’t know what to do with it and puts it in the hands of people who are struggling every single day.”

Existing law, the “Protect App-Based Drivers and Services Act,” created by Proposition (Prop) 22, a ballot initiative, categorizes app-based drivers for companies such as Uber and Lyft as independent contractors.

Prop 22 was approved by voters in the November 2020 statewide general election. Since then, Prop 22 has been in court facing challenges from groups trying to overturn it.

However, last July, Prop 22 was upheld by the California Supreme Court last July.

In a 2024, statement after the ruling, Lyft stated that 80% of the rideshare drivers they surveyed acknowledged that Prop 22 “was good for them” and  “median hourly earnings of drivers on the Lyft platform in California were 22% higher in 2023 than in 2019.”

Wicks and Berman crafted AB 1340 to circumvent Prop 22.

“With AB 1340, we are putting power in the hands of hundreds of thousands of workers to raise the bar in their industry and create a model for an equitable and innovative partnership in the tech sector,” Berman said.

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Activism

California Holds the Line on DEI as Trump Administration Threatens School Funding

The conflict began on Feb. 14, when Craig Trainor, acting assistant secretary for civil rights at the U.S. Department of Education (DOE), issued a “Dear Colleague” letter warning that DEI-related programs in public schools could violate federal civil rights law. The letter, which cited Title VI of the Civil Rights Act and the 2023 Supreme Court ruling in Students for Fair Admissions v. Harvard, which ended race-conscious admissions, ordered schools to eliminate race-based considerations in areas such as admissions, scholarships, hiring, discipline, and student programming. 

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Shutterstock

By Joe W. Bowers Jr
California Black Media
 

California education leaders are pushing back against the Trump administration’s directive to dismantle diversity, equity, and inclusion (DEI) programs in its K-12 public schools — despite threats to take away billions in federal funding.

The conflict began on Feb. 14, when Craig Trainor, acting assistant secretary for civil rights at the U.S. Department of Education (DOE), issued a “Dear Colleague” letter warning that DEI-related programs in public schools could violate federal civil rights law. The letter, which cited Title VI of the Civil Rights Act and the 2023 Supreme Court ruling in Students for Fair Admissions v. Harvard, which ended race-conscious admissions, ordered schools to eliminate race-based considerations in areas such as admissions, scholarships, hiring, discipline, and student programming.

According to Trainor, “DEI programs discriminate against one group of Americans to favor another.”

On April 3, the DOE escalated the pressure, sending a follow-up letter to states demanding that every local educational agency (LEA) certify — within 10 business days — that they were not using federal funds to support “illegal DEI.” The certification requirement, tied to continued federal aid, raised the stakes for California, which receives more than $16 billion annually in federal education funding.

So far, California has refused to comply with the DOE order.

“There is nothing in state or federal law that outlaws the broad concepts of ‘diversity,’ ‘equity,’ or ‘inclusion,’” wrote David Schapira, California’s Chief Deputy Superintendent of Public Instruction, in an April 4 letter to superintendents and charter school administrators. Schapira noted that all of California’s more than 1,000 traditional public school districts submit Title VI compliance assurances annually and are subject to regular oversight by the state and the federal government.

In a formal response to the DOE on April 11, the California Department of Education, the State Board of Education, and State Superintendent of Public Instruction Tony Thurmond collectively rejected the certification demand, calling it vague, legally unsupported, and procedurally improper.

“California and its nearly 2,000 LEAs (including traditional public schools and charter schools) have already provided the requisite guarantee that its programs and services are, and will be, in compliance with Title VI and its implementing regulation,” the letter says.

Thurmond added in a statement, “Today, California affirmed existing and continued compliance with federal laws while we stay the course to move the needle for all students. As our responses to the United States Department of Education state and as the plain text of state and federal laws affirm, there is nothing unlawful about broad core values such as diversity, equity and inclusion. I am proud of our students, educators and school communities who continue to focus on teaching and learning, despite federal actions intended to distract and disrupt.”

California officials say that the federal government cannot change existing civil rights enforcement standards without going through formal rule-making procedures, which require public notice and comment.

Other states are taking a similar approach. In a letter to the DOE, Daniel Morton-Bentley, deputy commissioner and counsel for the New York State Education Department, wrote, “We understand that the current administration seeks to censor anything it deems ‘diversity, equity & inclusion.’ But there are no federal or State laws prohibiting the principles of DEI.”

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