A California bill to fix the Medi-Cal assets test (AB 683 – Carrillo), jointly sponsored by Justice in Aging and Western Center, will not move forward this year.
The Medi-Cal assets rule limits the amount of assets an individual can have to $2,000, or $3,000 for a couple. While it does have exceptions (a home and one car), it still limits how much Californians can save to take care of themselves if they need help from Medi-Cal. Most Medi-Cal recipients don’t know about the exceptions, and don’t have access to financial advice to help save as allowed by the rule.
The real kicker, though, is that the assets test only applies to people over age 65 and some people with disabilities. How’s that for equity?
The test is not just some vague rule that only health policy advocates worry about. It’s an outdated measure of whether someone deserves health care that is even more strikingly anachronistic during the COVID-19 pandemic.
So what does this look like in the real lives of Medi-Cal recipients?
Alfred Calderón, 64, from Long Beach has been paraplegic since 1973. He’s been dealing with the ins and outs of both Medicare and Medi-Cal for some time since he is eligible for both programs. Medi-Cal is supposed to pick up where Medicare leaves off to cover premiums and high-cost sharing, which he can’t afford.
Like many Californians, Alfred’s family is spread out. His aging father lives on the other side of Big Bear, and his nieces and nephews live on the Pala reservation outside of San Diego. The only way for him to get around to visit family and friends is with a special van outfitted to meet his needs, but it’s impossible to save enough to buy such a van, since it would cost more than Medi-Cal allows Alfred to have as long as he wants to keep his health care. He says it’s hard to stay in community when there’s no way to visit his people.
Alfred is also unable to save for things like a comfortable bed, which would be helpful given his disability and age. While Medi-Cal pays for a basic hospital-type bed if medically necessary, he can’t save money for a bed that will ensure he can actually rest.
Alfred says he and his friends on Medi-Cal, “feel indentured – we need to ask for permission on how to live our lives.”
He’s right. While we have no problem with pandemic profiteering by California’s billionaires — who can’t possibly need another house, car, or luxury bed with personalized settings, the California public health care program is preventing Alfred from seeing people he cares about and getting a decent night’s sleep.
Beyond the comforts that make life feel more human and connected, the inability to save also puts many Medi-Cal recipients at risk of homelessness. When financial disaster happens – a layoff, an eviction, the car you need for your job breaks down, or the hot water heater needs replacing, a $2,000 cap on assets can make it impossible to bounce back.
The economic fallout of COVID-19 has shown just how easy it is for finances to be wiped out in the face of the unexpected. What’s worse, the Medi-Cal assets test rule targets those most at risk of COVID-19: elders with low incomes and people with disabilities who are also disproportionately people of color.
We need state policy that sets people up for success and treats them with the dignity that all Californians deserve. AB 683 would have corrected the most egregious parts of the Medi-Cal assets test: the low asset cap that hasn’t been updated since 1989, and the wonky rules only policy experts can explain.
But since the state won’t appropriately tax the rich, state leadership says we can’t afford to change these ridiculous rules – even though legislators across party lines agree it’s bad policy. So reports on health disparities and economic insecurity will keep coming, even when we know what fixes would make a difference. It is absolutely absurd that the state is stripping elders of what little assets they have to access health care, as it allows billionaires to hoard resources at unprecedented rates.
We’ll be back to get this bill through next year, but in the meantime, we hope state leaders reevaluate their priorities and actually commit to a more equitable California – rather than just saying they will.