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DHCS official discusses Medi-Cal unwinding data

California began redetermining Medi-Cal eligibility of members in April, and has since disenrolled 225,231 individuals, while 499,093 individuals have maintained their Medi-Cal coverage, according to Yingjia Huang, assistant deputy director of Health Care Benefits and Eligibility at the Department of Health Care Services (DHCS).

This week, Huang hosted a webinar with stakeholders to go over Medi-Cal unwinding information, and shared the state’s interactive dashboard to explain June data.

The diversity and volume of individuals in California make Medi-Cal redeterminations an extraordinary task for all involved, Huang said, adding that over 15 million Californians will undergo the process. DHCS began preparing for the unwinding several years ago when the federal public health emergency was put in place because they were unsure of when the emergency order would end.

The data on DHCS’s dashboard helps the department develop strategies and investments for supporting the Medi-Cal population, and helps the department decide whether it needs to alter messaging to members.

“This is the first time the department has ever posted something so early, which is 45 days after the actual last day of the coverage month of June,” Huang said, adding that DHCS usually reports data 90 days after June, or in October. “This is in the spirit of full transparency in the unwinding journey.”

Total Medi-Cal enrollment for June was 15,568,357 individuals statewide, with the first set of disenrollments taking place on July 1st. While the state continues to conduct redeterminations, individuals are continuing to sign up for coverage. In June, DHCS received 143,069 applications in total, 125,145 of which were determined to be eligible for Medi-Cal coverage or the Children’s Health Insurance Program.

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Western Center on Law and Poverty suggests California pauses Medi-Cal disenrollments that are due to procedural reasons

With Medi-Cal redeterminations underway following the end of the federal public health emergency, the Western Center on Law and Poverty (WCLP) is concerned about recently released data from the state, which shows that 225,231 individuals have been disenrolled from the program so far.

For the renewal period beginning in April, a total of 1,052,030 individuals underwent a renewal, of which 199,852 were terminated due to procedural reasons. Procedural reasons may include being unable to complete renewal packets, and the state not having up-to-date contact information for beneficiaries. David Kane, senior attorney at WCLP, spoke with State of Reform about his concerns with the high level of terminations.

WCLP has been working with California’s Department of Health Care Services for over three years to prepare for this redetermination process. WCLP meets with the agency twice per month and reports challenges they hear about from the community. The Center also advocates for policy changes that will make it easier for Californians to renew and maintain coverage.

The state says procedural errors occur when individuals fail to turn information in, but Kane said many are attempting to renew their Medi-Cal but run into roadblocks. Bumps occur when individuals attempt their annual renewal through the phone—which is critical for those who don’t have a physical address—need to conduct the renewal during their lunch break, or don’t receive paperwork in the language they speak. Phone wait times have also increased, with LA County having hold times of 45 minutes to one hour.

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Tens of thousands lose Medical eligibility

About 225,000 Californians lost their free or low-cost health coverage as of July 1st in the first round of a Medi-Cal renewal process – which had been suspended since early in the COVID-19 pandemic.

The number makes up more than 20 percent of the 1 million or more people who were due to reapply for coverage in June.

Less than three percent of those who lost coverage lost it because their incomes now exceed program limits. Most lost it because they didn’t submit a renewal packet and could not have their incomes verified.

Staff attorney David Kane told CalMatters “I don’t think today’s preliminary numbers mean we can all sit back and think things are OK, these disenrollments are not inevitable.” He added that the lack of responses could be due to not receiving the packets or not getting the packets in their language.

Anthony Cava of the California Dept. of Public Health told KALW that it’s not too late for some residents to hold on to their Medi-Cal coverage. If you’ve lost your insurance, Cava advised Californians to: return packets to their county office; notify them if you’ve moved; and to return any yellow envelopes promptly.

The state will review eligibility for about 16 million people over the next year. Those who were dropped from Medi-Cal on July 1st have 90 days to re-apply for reinstatement.

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Thousands dropped from Medi-Cal in first eligibility check since the start of the pandemic

New data shows Sacramento County disenrolled 9,650 people from Medi-Cal in June. It was the first time in three years it and all other California counties have checked for eligibility.

The majority of people who were dropped did not return the renewal packets that were sent to the last address the county had on file. The same is true on the state level. Of the 225,000 California residents who were disenrolled in June, almost 9 in 10 were dropped because they didn’t complete the renewal paperwork.

“It’s extremely troubling,” said David Kane, senior attorney at Western Center on Law and Poverty. “Nobody looked at their cases and said, ‘you’re over income or you no longer qualify.’ They were cut off merely for paperwork reasons.”

Kane said many people have changed their addresses in the past three years, and may have never received the packet. Meanwhile, in Sacramento, community health workers say long wait times and a lack of communication from the county make it difficult to help people renew their coverage.

Medi-Cal, California’s low-to-no-cost insurance program for people with very low incomes, is in the first month of a yearlong renewal process.

Throughout the COVID-19 public health emergency, a federal policy called “continuous coverage” ensured that people could join Medi-Cal but could not be taken off. When the public health emergency ended this spring, counties began checking whether people were still eligible for the first time since 2020.

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Over 34,000 L.A. County households lost Medi-Cal in July amid rollback of COVID rules

More than 34,000 households in Los Angeles County have had their Medi-Cal coverage discontinued this month as California joins other states in beginning to cut off people from Medicaid programs who no longer meet income requirements or whose paperwork was not submitted in time.

The latest numbers were shared by L.A. County officials at a public meeting Wednesday. Health officials and legal advocates are closely eyeing such early figures to see how a major shift in health coverage is playing out in L.A. County and across California, amid concerns that people who legally qualify for Medicaid could end up losing it unnecessarily or suffering interruptions in their coverage.

Earlier in the pandemic, federal rules had allowed people to hang on to Medicaid coverage without turning in annual paperwork to prove they were still eligible. Now states have started ejecting people from their programs again after the federal government rolled back those pandemic rules.

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Tens of thousands of L.A. County residents could soon lose Medi-Cal coverage. Here’s why

Tens of thousands of people in Los Angeles County could lose their Medi-Cal coverage in July, according to preliminary data provided to a health plan that serves Angelenos on the public program.

L.A. Care, a publicly operated health plan in L.A. County, said that early data provided by the state indicate that roughly 40,000 of its members enrolled in Medi-Cal could lose their coverage this month, although final numbers are still pending.

Those figures do not include Medi-Cal recipients who are not covered by L.A. Care, which serves roughly 2.7 million of the nearly 4.7 million people in L.A. County who were enrolled in Medi-Cal as of this spring, according to state figures. The numbers are expected to keep shifting as more people return paperwork that was due Friday to renew their coverage in California’s Medicaid program, the beginning of a process that will play out over the next year.

But the tentative figures are an early sign of the serious shift underway as the federal government has rolled back rules that helped people stay on Medicaid, one that has troubled health providers and advocates who fear many patients will unnecessarily lose medical coverage for which they qualify.

“Losing Medi-Cal coverage is not a mere inconvenience or annoyance,” said David Kane, an attorney at the Western Center on Law & Poverty. “For far too many it can be life-threatening. It can mean that transportation to dialysis does not show up. Surgery is canceled. You cannot pick up your prescription drugs.”

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