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Increasing paperwork and bureaucracy for struggling working families on Medi-Cal
means more children will lose health insurance—even if they are eligible
to receive it. The new requirement on families to re-apply to keep their Medi-Cal
coverage every six months (Mid-Year Status Reports) could lead to almost 100,000
families losing Medi-Cal coverage next year if they do not resubmit eligibility
paperwork every 6 months. Most of these families will still be eligible but
will have no health insurance, placing pressure on local programs and public
hospitals, and putting their health at risk.
What is the Impact of Mid-Year Status Reporting?
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Families already have to report income changes within the year and must
re-apply every year.
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Re-applying every six months simply serves to erect intentional obstacles
to continued coverage.
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Almost all families, even with an increase in family income in the
middle of the year, would still be eligible for at least another year.
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A key purpose of the new requirement is reducing Medi-Cal costs, which
only happens if people lose health insurance—whether or not they
are actually eligible for the insurance.
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While lost Medi-Cal coverage reduces state expenditures, the state
also loses federal matching funds to cover health care needs in California.
Why Does This Hurt Kids?
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Although children are supposed to be guaranteed continuous Medi-Cal for
a full year, existing county systems may cut off the entire family if parents
do not submit paperwork every 26 weeks.
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Children are usually part of the same "case" as their parents.
To avoid dropping the children’s coverage requires caseworkers and computer
systems to separate family members who must re-apply every six months from
children who are not required to do so. This complicated process requires expensive
reprogramming that could take up to 9 months to implement—if the
county chooses to make system changes. The alternative is training caseworkers,
who may have
600 cases, to manually reinstate children who would have lost coverage.
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Each time a child who uses a health plan loses Medi-Cal—even by
accident—and is reinstated, the child must use fee-for-service
for up to 2 months before rejoining. In that interim period, the fee-for-service
coverage
might not include their previous provider. And even when they choose
a
health plan again, there is no guarantee that they can rejoin the same
health plan.
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Research shows that children are more likely to be enrolled in health
insurance and receive regular health care if their parents are also covered.
If a parent loses coverage because of confusing and burdensome reporting
rules, their children's health can suffer.
Which Families Are Affected?
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Most of the 1 million people affected are very low-wage workers who do
not receive cash aid.
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Mid-year reporting impacts people who are already required to report
income changes within 10 days, and whose earnings can already be monitored
through the state's wage reporting system.
Even worse than mid-year reporting, the Governor continues to propose increasing
the reporting from every 6 months to every 3 months (or quarterly). This proposal
could lead to almost 200,000 families losing Medi-Cal next year. California
had abolished quarterly reporting in 2000, with bipartisan support, in order
to simplify the process and retain coverage for eligible families. Unfortunately,
in the context of budget deficits, the Governor and Legislature are choosing
to move backward by returning to extra reporting requirements, knowing that
eligible families will lose their coverage.
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