Thousands of Californians losing Medi-Cal coverage

Currently, 1.6 million Californians have been disenrolled from Medi-Cal due to the state’s process reviewing insurance records and disenrolling enmasse those who were once covered under COVID-19 pandemic extensions. Hailing from El Cajon, The Children’s Partnership President Mayra Alvarez, a state advocacy promoting child health equity is increasing pressure on Gov. Gavin Newsom to approve continuous coverage for children 0-5 in his May budget revisions to help the tens of thousands of children who could unnecessarily lose medical coverage in the weeks ahead.

Alvarez said Medi-Cal works well for children in our communities.

“When we think about the importance of health insurance, it only comes to mind, only when we need it,” she said. “We know that health insurance coverage and access to healthcare plays a critical role in all our lives. Every family. Every child. You can think about the pandemic and why it was so important to have access to healthcare services.”

Alvarez said in the state, there are about 15 million people that depend on the Medi-Cal program for the security of health insurance coverage, and that includes 5.7 million children. In San Diego County that is nearly 350,000 children and youth up to age 18 that are enrolled in the program.

“This is not a small amount of people that are looking to the Medi-Cal program for that security,” she said. “The majority of people enrolled in Medi-Cal are communities of color. Almost 70 million children enrolled in Medi-Cal are children of color. It is a lifeline for millions of Californians.”

Alvarez said health insurance coverage is especially important in the first few years of a child’s life. As a relatively new mother, she said she has been to the doctor in the past couple of years than she has in her whole life.

“You must go to the doctor. They need those well-child visits and developmental screenings, and immunizations, just to make sure they are on the right path to healthy childhood development. We also know scientists tell us that 90% of the brain develops in those first five years of lives,” she said. “We want to make sure that parents and caregivers have those tools they need to think of their child’s health first. Health insurance coverage and a strong Medi-Cal program is part of that.”

Alvarez said over the past few years, it has done focus groups with families on Medi-Cal and how important it is to have it, and how unexpected the news is when they have been able to go to the doctor, just to find out they do not have health insurance anymore. And that is because during the public health emergency during the pandemic, the federal government allowed the Medi-Cal, the Medicaid program allowed people to be continuously enrolled. Generally, every year, families must redetermine their eligibility from an income-driven perspective. Since June, California began requiring families to reenroll. She said many people were reached through mail, phone calls, emphasizing the need to reapply.

“People are busy. They may have moved. They may have been confused and not known what to do. They may have tried to respond. Frankly, waiting an hour and a half to two hours is difficult for someone trying to go to work, make dinner. And maybe it just got lost,” she said. “As a result, over 1 million people in California have lost coverage. Over 300,000 children have lost coverage, including 15,750 children in San Diego County.”
Over 90% of people losing coverage are for procedural reasons, she said. Meaning that it is administration barriers causing the problem.

“An overwhelming majority of folks are qualified for the program, and they are losing that coverage unnecessarily,” she said. “We are trying to get to a place where that is not happening, and to a place where the program is working for people. We want to make sure that people understand that Medi-Cal is a strong program and will be there for them. Part of that is trying to improve it.”

Alvarez said they are trying to improve it in two ways. First, the state enacted a policy to keep children 0-5 continuously enrolled in Medi-Cal. But the legislator and governor moved it forward on a conditional basis. It will not move forward until it has financial approval from the Department of Finance.

“We are waiting too long. Hundreds of thousands of kids have lost coverage. The time is now. There is already a commitment from our elected officials, so we want to see the governor to greenlight the policy for implementation in his May budget revise so the Department of Human & Health Services can start to move it forward and make this policy operational,” she said.

Second, Alvarez said as children’s advocates, they realize that children are more likely to have health insurance if their guardians have it. So, they are supporting Assembly Bill 2956 by California 77th District Assemblymember Tasha Boerner, which seeks to stop Medi-Cal disenrollments in California.

“That would help strengthen the program for people. Make it easier to stay enrolled,” she said. “There are policies that were in place during the pandemic, and we want them to continue because we know it makes it easier for families. This is about our families and our community members have a Medi-Cal program that works for them and that they can access the health care they need to stay healthy.”

Alvarez said The Children’s Partnership is a California advocacy organization that focuses on child health equity in partnership with state and local organizations to advance shared agendas for whole-child well-being. She said that includes health insurance, community and food inequities. Immigration, and how all those factors impact the well-being of children.

Alvarez said to advance this policy, it is important for community members to talk to each other and let them know the problem, and what solutions are being provided now to help solve them. She said contacting local and state representatives in support of AB 2956.

“They can call their elected officials and let them know it is important to move this bill forward,” she said. “When it comes to continuous coverage of Medi-Cal in the budget, we strongly encourage folks to call their elected officials, and the governor, to make sure they are prioritizing this important policy change.”

To easily send a letter to Gov. Gavin Newsom, CA HHS Secretary Mark Ghaly, and CA Department of Finance Director to encourage them to fund a multi-year continuous Medi-Cal coverage for children ages 0-5, visit https://actionnetwork.org/letters/protect-childrens-medi-cal-health-care-coverage.

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