$600 a month. Imagine living on that in an expensive state like California. That’s exactly what the state requires older adults and people with disabilities to do in exchange for health care through Medi-Cal. This year, the California Legislature and Governor Newsom must change that. Health care is one of the most expensive basic needs in our society — any commitment by state leaders to address inequality must include health care.
AB 1900 by Assembly member Arambula and co-author Assembly member Wood, which Western Center is co-sponsoring with Justice in Aging, Bet Tzedek Legal Services, Disability Rights California, Senior & Disability Action, and California Advocates for Nursing Home Reform, will address the problem by increasing the amount of monthly income older adults and people with disabilities can keep for basic needs.
Currently, elders and people with disabilities with incomes below $1,564 a month qualify for free Medi-Cal. But low-income older adults and people with disabilities who are just a $1 over the limit are required to pay over $900 of their monthly income as a share-of-cost.
The share-of-cost works like a health insurance deductible, but resets on a monthly basis. This Medi-Cal program establishes a monthly amount that older adults and people with disabilities are allowed to keep to meet their basic needs, called the maintenance need income level. The rest of their income must go toward health care expenses. The maintenance need income level of $600 hasn’t been changed since 1989, even though it is nearly impossible for anyone in California to live on $600 a month now.
By increasing the amount of monthly income older adults and people with disabilities can keep for their basic needs — up to 138% of the federal poverty level (the Medi-Cal income level for nearly all adults), AB 1900 ensures that older adults and people with disabilities don’t have to wait another 30+ years for an adjustment since the federal poverty level is updated every year.
Most people with low incomes receive their health care for free or pay up to 8.5% of their income on health care coverage. It is unfair that older adults and people with disabilities are the only population forced to pay over 60% of their income to obtain essential health care. The current policy forces aging adults, people with disabilities and their families to make impossible choices between health care, paying rent, and affording food. When people cannot access needed Medi-Cal services they often end up hospitalized or institutionalized, or forced to rely on already stretched family members to provide unpaid care.
Ten other states have higher maintenance need income levels than California. It’s time to ditch the deductible and lead the nation in health care affordability. State leaders must fund AB 1900 in this year’s state budget.