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State Agencies Looking to Keep Californians Insured

-Editorial

Some California residents are at risk of losing their insurance in the next year but some programs will help them remain insured and continue taking care of their health. 

It is expected that between June 2023 and May 2024, more than 15 million Medi-Cal members — one-third of California’s residents — will have their eligibility redetermined as part of the “great unwinding” of Medicare enrollees now underway across the country.  

Ethnic Media Services hosted a panel to discuss how will these cuts affect the most vulnerable population of the state.  

The speakers on this panel were Yingjia Huang, Deputy Director of health care benefits and eligibility, Department of Health Care Services; Jessica Altman, CEO, of Covered California; Virginia Hedrick, Executive Director, of California Consortium for Urban Indian Health; Louise McCarthy, CEO of Community Clinic Association of LA County; Dr. Seciah Aquino, ED, Latino Coalition for a Healthy California; Mayra Alvarez, President of Children’s Partnership. 

“We are implementing meaningful changes to make it easier for our members to stay covered next year,” said Yingjia Huang, Deputy Director of health care benefits and eligibility. “We are also enrolling new members into our program so it’s important for us to provide the resources to help the transition to other programs if they don’t qualify for Medical.”

California has unenrolled 21 percent of the members that were up to redetermination. 

“Most of the people that were discontinued was because they didn’t return their renewal packet,” Huang said. 

The Department of Health Care Services (DHCS) released a new report highlighting a notable increase in the number of Californians accessing and utilizing the wide array of benefits and services provided by the Medi-Cal program’s Enhanced Care Management (ECM) and Community Supports, which DHCS launched in January 2022 under Governor Newsom’s California Advancing and Innovating Medi-Cal (CalAIM) initiative.

The report outlines the positive impact of ECM. More than half of Medi- Cal members enrolled in ECM in 2022 were individuals who were at risk of avoidable hospital or emergency department visits, more than 42,000 were members with serious mental health/substance use disorder needs, and more than 36,000 members were individuals experiencing homelessness. DHCS expects even more Californians to use these expanded Medi- Cal services in 2023 and 2024 as eligibility expands to new members or populations of focus, and as more providers contract with Medi-Cal managed care plans (MCPs) to deliver these vital services.

Jessica Altman, CEO, of Covered California said they are working to help as many people as possible to keep their insurance. 

“The goal is to keep anyone that is still eligible for Medi-Cal. We know that there might be changes to income and employment where some people will no longer be eligible. That’s where Covered California will step in helping those transitioning with robust financial assistance that will help pay for monthly premiums often to little or no cost,” Altman said. “Californians that lose Medi-Cal coverage will be able to get coverage at little or no cost. Early data shows that a third of those that come from Medi-Cal are finding $0 premiums at Covered California and 90 percent pay $10  or less for their health insurance.” 

According to the Public Policy Institute of California, the state has seen dramatic declines in the number of uninsured residents since 2014, when major coverage expansions under the Affordable Care Act (ACA) were implemented. About 93 percent of Californians now have health insurance coverage, up from 82.5 percent in 2013; this translates to about 5 million fewer uninsured state residents. Medi-Cal, the state’s Medicaid program, is responsible for much of the coverage gain, while Covered California, the state’s insurance marketplace, continues to see robust enrollment.

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