Health

Covered California Continues to Terminate Some Customers

Published

10 years ago

April 2, 2016

By Emily Bazar, Kaiser Health News

It wasn’t until a doctor ordered medical tests for Adriana Vitale that she discovered her Covered California coverage had disappeared.

“I was shocked. I was crying. I was depressed,” said Vitale, 61, of Downey, California

Her insurance had been dropped, even though she had paid all her premiums on time.

She’s not the only one. A number of people who have signed up for Covered California coverage have been dumped from their plans unexpectedly, without explanation — even though their premium payments were up to date.

Others were shifted into Medi-Cal without approval or consent. They found out after the fact.

It’s been a persistent, but apparently unquantified problem, since 2014.

In Vitale’s case, she went to the hospital in December for a bleeding ulcer. Her daughter called the insurance carrier, Blue Shield, to confirm that her mother’s follow-up tests would be covered.

“They said, ‘We don’t have anyone by your mom’s name covered by Blue Shield. But we have all these medical bills in her name,’” the daughter, Kathy Castilla, recalled.

It took an administrative law judge in late December to resolve the problem. He ordered Vitale’s policy reinstated.

He noted that neither Blue Shield nor Covered California could explain why Vitale’s policy had been terminated without her request.

“The failure to be able to explain these discrepancies casts doubt on Blue Shield and/or [Covered California] record keeping as it applies to appellant’s coverage,” he wrote.

Several other customers whose paid-up policies disappeared talked to California Healthline about their plight, as did health care advocates who help them unravel the bureaucratic knots.

The evidence is anecdotal. Not even Covered California knows how many people might be affected.

“We are not aware of anything that would result in the terminations of a large number of consumers without notification, or of any problems with our process of notifying consumers who are deemed eligible for Medi-Cal,” spokesman Larry Hicks said.

When pressed further on whether Covered California is aware of the termination problem and if so, how many people it affects, Hicks issued this statement: “While we want every enrollment and transition to be as smooth as possible, we know that with 1.5 million consumers, there will be times when issues come up that need to be resolved. We deal with these on a case-by-case basis as we discover them and, where appropriate, look for ways to improve our existing processes.”

No one seems to know what’s causing these terminations. Nor is it clear whether they’re a result of errors committed by Covered California or the health insurance plans — or both.

Blue Shield declined to comment on Vitale’s case, citing privacy concerns, but said there are several reasons why someone’s plan might be terminated. These include non-payment of premiums, not providing proof of citizenship and changes in income that would make the person ineligible for a subsidized Covered California plan, the insurer said.

None of those seem to apply to Vitale.

“Blue Shield is committed to providing coverage to all Californians — this includes working closely with Covered California to decrease the state’s uninsured rate,” said spokesman Clinton McGue.

Covered California’s Hicks suggested that consumers who face problems with their coverage and are unable to resolve it with their insurer contact the exchange’s customer service center at 800-300-1506.

Vitale’s daughter said she tried that. The service center acknowledged an “error,” but when she asked whose it was, “they didn’t want to tell me,” she said. The agent did tell her the problem would “take a while to fix.”

The family turned to Neighborhood Legal Services of Los Angeles County, which helped them take the case to the administrative law judge.

But Vitale still hasn’t had her medical tests, in part because it has taken so long to get her coverage reinstated, despite the judge’s order.

“I wish they would never do this again to another person,” she said. “It’s a terrible thing.”

Wendy Heath of San Diego also contacted Covered California’s help line after her policy was dropped. She said she had renewed her Health Net policy through the exchange and paid her January premium. When her February invoice didn’t show, she called Health Net.

“They said, ‘You don’t need to pay us. As a matter of fact, we’ve refunded the amount you paid for January,’” Heath, 39, recalled. “They said, ‘Your plan was canceled by Covered California.’”

When she called Covered California, she said, a representative could only acknowledge that “we’ve seen the issue” with her case. Eventually, she got her coverage restored with the help of a community service group, San Diegans for Healthcare Coverage.

In the meantime, she had canceled two physical therapy appointments, afraid she might not be covered, she said.

Health Net spokesman Brad Kieffer said policyholders having trouble with their coverage should call the plan at 888-926-4988.

“This is not the experience we want for our members,” he said. “Anybody who feels that this has happened to them can call us and we’ll look into it and resolve the matter on their behalf.”

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Commentary

Doctors Seeing More Cases of Preventable Childhood Illnesses

OAKLAND POST — Physicians have said vaccine skepticism has expanded beyond childhood immunizations. Doctors also reported growing resistance to other preventive treatments.

Published

2 weeks ago

June 17, 2026

bpusa-syndication

By Stacy M. Brown

Doctors across the United States say they are treating children for illnesses that routine vaccinations once made increasingly uncommon, raising concerns that years of declining immunization rates are beginning to reverse decades of public health progress.

Pediatricians have described seeing more cases of whooping cough, rotavirus infections, bacterial pneumonia and other potentially life-threatening illnesses that vaccines have long helped suppress. Some physicians reported treating conditions they had rarely encountered during their careers, while others said that growing vaccine hesitancy is changing how emergency rooms and hospitals care for children.

The reports come as measles outbreaks continue to spread across multiple states and vaccination coverage remains below federal public health targets.

Johns Hopkins University’s International Vaccine Access Center reported 2,077 confirmed measles cases nationwide as of May 29. Researchers warned that outbreaks reported across the country have raised concerns about continued transmission, additional hospitalizations and deaths, and the possible loss of the nation’s measles elimination status.

Public health experts have long viewed measles as a warning sign because of its ability to spread rapidly through communities with lower vaccination coverage. The New York Times reported that physicians increasingly fear the resurgence of measles may be followed by the return of other vaccine-preventable diseases.

Doctors say that is already happening.

Dr. Meghan Hofto, a pediatric hospitalist at the University of Alabama at Birmingham, said she has already treated roughly as many children with rotavirus this year as she saw during the previous decade. Rotavirus once caused tens of thousands of hospitalizations annually before vaccines sharply reduced its spread. None of the children she treated this year had been vaccinated.

Hofto also described caring for infants with pertussis, commonly known as whooping cough.

“It’s hard to know when they’re safe to go home,” Hofto told The Times.

The rise in whooping cough cases has been particularly striking. More than 28,000 cases were reported nationwide last year, compared with approximately 7,000 in 2023, according to figures cited by The Times. Many of the affected infants were too young to receive vaccinations themselves and relied on broader community protection to reduce their exposure.

Other doctors described similarly troubling cases.

Dr. Jessica Kirk, a pediatric hospitalist in Alabama, recently treated an unvaccinated toddler hospitalized with pneumonia caused by simultaneous infections of Haemophilus influenzae and Streptococcus pneumoniae. Vaccines exist to protect against both illnesses. The child required oxygen and antibiotics to recover.

Researchers at Johns Hopkins have been tracking vaccination trends nationwide and found continuing signs of vulnerability.

At the same time, vaccine policy has become increasingly contentious in state legislatures.

Johns Hopkins researchers reported that lawmakers across the country continue to introduce bills affecting childhood vaccination requirements, vaccine access and non-medical exemptions. Researchers also noted that state policies governing exemptions remain a significant factor in vaccination coverage and disease transmission risks.

Physicians have said vaccine skepticism has expanded beyond childhood immunizations. Doctors also reported growing resistance to other preventive treatments.

For doctors confronting the return of illnesses that vaccines once pushed to the margins of American medicine, the challenge is becoming increasingly personal.

“It just feels like you’re a tiny little boat with a giant tidal wave coming at you,” Dr. Erin Charles, a regional pediatric hospitalist at Seattle Children’s Hospital, told reporters. “And you might convince one family here and there.”

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Community

Asm. Isaac Bryan’s Environmental Reparations Bill Passes on Assembly Floor

“All this bill does is allocate resources from that repair fund and direct cash assistance to families that have had negative health impacts as a result of living next to that oil field,” said Bryan during remarks on the Assembly floor.

Published

2 weeks ago

June 17, 2026

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Asm. Isaac Bryan (D-Ladera Heights). File photo.

By Bo Tefu, California Black Media

On May 26, the California State Assembly passed legislation to provide direct financial assistance to families harmed by pollution from a major urban oil field in South Los Angeles.

Assembly Bill (AB) 1661, introduced by Assemblymember Isaac Bryan (D-Ladera Heights), cleared the Assembly floor with a 44-10 vote after lawmakers concluded debate on the measure.

The bill would direct money from a community repair fund toward families who suffered negative health effects from living near what Bryan described as the state’s largest toxic urban oil field. The repair fund was created under legislation approved two years ago that shut down the oil field and required polluters to contribute financially to community recovery efforts.

Bryan called the proposal “the largest environmental reparations opportunity for South LA” and told lawmakers the bill had not received opposition during the legislative process.

The legislation is part of California’s broader push to address environmental justice concerns in communities historically exposed to industrial pollution. South Los Angeles residents and environmental advocates have long raised concerns about health risks associated with oil drilling operations near homes, schools and parks.

Supporters say the measure represents a new approach to environmental accountability by ensuring that communities affected by pollution directly benefit from funds collected from responsible companies.

After debate concluded, Assembly leadership opened the roll call vote, and the measure passed with majority support from lawmakers.

AB 1661 now moves to the Senate for further review.

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Activism

Rep. Kamlager-Dove Introduces Bill to Protect Women in Custody After Reports Detailing Miscarriages and Neglect

The Pregnant Women in Custody Act would expand safeguards beyond the federal prison system to include women detained by U.S. Immigration and Customs Enforcement, U.S. Customs and Border Protection and the Office of Refugee Resettlement. The proposal follows reports of pregnant women being shackled, denied medical care and suffering miscarriages while in immigration detention.

Published

2 months ago

May 17, 2026

Oakland Post

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By Bo Tefu, California Black Media

Congresswoman Sydney Kamlager-Dove (D-CA-37) on May 7, reintroduced updated legislation aimed at strengthening protections and healthcare standards for pregnant and postpartum women held in federal custody, including in immigration detention facilities.

The Pregnant Women in Custody Act would expand safeguards beyond the federal prison system to include women detained by U.S. Immigration and Customs Enforcement, U.S. Customs and Border Protection and the Office of Refugee Resettlement. The proposal follows reports of pregnant women being shackled, denied medical care and suffering miscarriages while in immigration detention.

The legislation builds on a bipartisan version previously passed by the House during the 117th Congress. The updated bill includes new standards for healthcare access, mental health and substance use treatment, high-risk pregnancy care, family unity protections and increased federal oversight.

“Proper pregnancy care is a human right, regardless of your immigration or incarceration status,” Kamlager-Dove said in a statement. “It’s unacceptable that there are virtually no legal safeguards for pregnant women in federal custody.”

The bill would also limit the use of restraints and restrictive housing for pregnant women, improve data collection on maternal health in custody and require additional staff training and enforcement measures.

Supporters of the measure said the legislation is intended to address long-standing concerns about maternal healthcare and safety in detention settings, particularly for Black women and low-income women who are disproportionately impacted by incarceration and health disparities.

“Pregnant women in custody should never be subjected to dangerous and inhumane treatment that threatens their health, dignity, or the well-being of their babies,” said Patrice Willoughby, chief of policy and legislative affairs for the NAACP and a longtime public policy and government affairs strategist, in a statement.

A 2021 report estimated there are about 58,000 admissions of pregnant women into U.S. jails and prisons each year. Kamlager’s statement also cited a recent investigation by NBC News and Bloomberg Law that identified allegations of severe mistreatment or medical neglect involving at least 54 pregnant women or families in county jails between 2017 and 2024.

Federal policy under the Department of Homeland Security restricts the detention of pregnant, postpartum and nursing immigrants except in extreme cases. However, the agency reported that ICE deported 363 pregnant, postpartum or nursing women between January 2025 and February 2026, including 16 recorded miscarriages during that period.

The bill is cosponsored by several House Democrats and backed by organizations including the NAACP and the Vera Institute of Justice.