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Tag: Medi-Cal

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‘Extremely frustrating:’ How tech breakdowns are hurting Gavin Newsom’s coronavirus response

“Lawyers who work with low-income clients continue to hear from people who have lost coverage even after the counties were notified, said David Kane, a lawyer who works for the Western Center on Law and Poverty. The state should be working harder to fix the problem, which is leaving vulnerable people without coverage in the middle of the pandemic, Kane said.

“It’s August, and they still haven’t completely fixed it,” Kane said.”

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In the midst of the pandemic, California continues to strip assets from elders with low incomes in exchange for health care.

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 It’s an outdated measure of whether someone deserves health care that is even more strikingly anachronistic during the COVID-19 pandemic.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.

 

Update on the 2020-21 California Budget

On Monday, June 15th, the California Legislature met the state constitutional deadline for passing the 2020-21 budget by approving a new state budget. At this time, it is unclear if the Governor will support the budget, as no deal has been announced.

The Legislature approved this budget to uphold its constitutional duty, but it is not the final version. The COVID-19 pandemic has caused unprecedented economic and public health uncertainty, and it has highlighted and exacerbated every existing inequity the state has failed to address. On top of the pandemic, social unrest calling for justice and equality for Black people has created a demand for leaders at every level to do things differently to dismantle entrenched white supremacy. If the Governor and Legislature simply ram through a budget deal, it will disproportionately harm Black people and other communities of color – as the economics of this state always do.

Forthcoming actions on this budget by the Legislature and Governor must take into account the needs of ALL Californians. The state’s economics must change — that includes increasing revenue through taxes on extreme wealth, and not making cuts to the programs millions of Californians rely on.

The budget approved by the Legislature rejects the vast majority of cuts proposed in the Governor’s May Revision budget, and includes several program expansions sought by advocates. The Legislature’s budget includes a trigger mechanism that is substantially different than the one proposed by the Governor. The trigger approved by the Legislature would not take effect until October 1, 2020, and will be “triggered” if the U.S. Senate and President fail to approve the $14 billion in assistance to states that the House of Representatives approved last month, on a bi-partisan basis.

To bring the budget into balance if federal leaders fail to deliver additional funding, the Legislature’s trigger would utilize reserve funding, deferrals of school funding, delays in previously approved spending, and state employee compensation reductions. It would not include most cuts to health programs, CalWORKs, SSI, IHSS, or programs for elders, which were proposed by the Governor. More details are available here.

The Legislature’s budget does include some program corrections, restorations, and expansions — notably, it ends the exclusion of immigrant workers with Individual Tax I.D. Numbers (ITINs) for the state Earned Income Tax Credit (CalEITC), restores the CalWORKs lifetime limit for adults to 60 months, provides another $350 million for homeless programs, and provides COVID-19 inspired CalFresh program simplifications and out-of-office technology advancements. All of these proposed changes are subject to ongoing negotiations, and until a “deal” is announced, we won’t know if they are in the final budget.

For health care, Western Center supports the Legislative budget’s rejection of cuts proposed in the Governor’s May Revision. The Legislature’s budget protects the health of California’s elders and communities of color in several ways. It does not reinstate the senior penalty by raising the Medi-Cal Aged & Disabled income limit, per last year’s budget. It rejects Medi-Cal benefit cuts and limits estate recovery, which disproportionately seizes homes from Black, Latinx, and API families. It also restores funding for the Black Infant Health program and for health navigators, and expands Medi-Cal to elders regardless of immigration status, though, Western Center would like to see that implemented sooner.

The Legislature’s budget recognizes the need to address the state’s homelessness crisis for unhoused community members, while also preventing additional homelessness. The budget allocates resources for traditional interventions, as well as funds to increase permanent housing options through the expansion of the low income housing tax credit, acquisition of hotels and motels which may appropriately serve as longer-term housing resources, and funds for the provision of legal assistance to low-income households that may be threatened with displacement or eviction. Given the magnitude of California’s housing challenges, which are compounded by the COVID-19 pandemic and ensuing responses, we look forward to building on this foundation.

Commentary: Revised budget puts older Californians, communities at risk

No one expected good news when Gov. Gavin Newsom announced the May Revision of the California budget. As the COVID-19 pandemic obliterates plans and economies, there was no expectation that California’s budget would go unscathed. However, we never predicted the biggest blow would go to California’s older adults.

 

Here’s how a $54 billion deficit will hurt Californians

“Since eyeglasses and hearing aids are not required by the federal government, they are most likely the first benefits to be cut by the state, said Linda Nguy with the Western Center on Law and Poverty.

Health advocates sought to expand Medi-Cal to undocumented seniors, but the proposal will be a tough sell in the current environment. “I think this is a message to temper our expectations,” Nguy said.”