A year ago, as the federal COVID-19 emergency officially ended, California commenced reviewing eligibility for Medi-Cal, its Medicaid equivalent, affecting one-third of their residents.

While numerous states are using this review to drop Medicaid members in large numbers. Texas, for instance, has removed over two million members since the pandemic-era protections were lifted, and Florida removed nearly one million. California is leading efforts to not only maintain but expand health coverage.

In a media briefing on April 16, hosted by Ethnic Media Services, a panel of experts and Medi-Cal enrollees discussed the impact of the review on enrollment, efforts to retain eligible members, and the significance of Medi-Cal services.

Speakers

  • Yingjia Huang, Assistant Deputy Director, Health Care Benefits and Eligibility (HCBE), California Department of Health Care Services
  • Vilma Champion, Director, Managed Care and Enrollment, Northeast Valley Health Corporation (NEVHC)
  • Griselda, Medi-Cal enrollee (not pictured)
  • Fitzgerald Graves, Medi-Cal enrollee, African American Network of Kern County
  • Dara Montejo, daughter of newly enrolled undocumented mother

The nationwide Medicaid review, known as “the great unwinding,” is considered “one of the biggest healthcare events after the Affordable Care Act,” according to Yingjia Huang. It concludes next month, in May 2024. California has successfully renewed nearly 15 million Medi-Cal members amidst this process.

In November 2023, with one million Californians up for renewal, the state experienced a 21 percent disenrollment rate due to either ineligibility or paperwork errors. However, DHCS streamlined the online enrollment process in December, reducing the disenrollment rate to about 9 percent. The trend continued to improve in January and February, with disenrolled individuals having a 90-day window to re-enroll without coverage gaps.

The cumbersome redetermination packet posed a significant challenge, particularly for members who joined during the pandemic and hadn’t undergone redetermination before. To assist members, DHCS automated the process, created instructional videos, and offered multilingual outreach for phone or online enrollment.

In January 2024, DHCS expanded Medi-Cal to include eligible undocumented individuals of all ages, adding approximately 700,000 people to full-scope benefits. Despite the challenges of the unwinding, DHCS is proud of its achievements.

The expansion of Medi-Cal to all, regardless of citizenship or immigration status, is deemed crucial for community health and brings California closer to universal healthcare, as noted by Vilma Champion.

With the expansion, NEVHC anticipates serving over 6,000 newly eligible patients and has assisted over 5,000 patients in re-enrolling during the unwinding, primarily monolingual Spanish speakers from immigrant backgrounds.

To ensure access to care, especially for those with public charge or immigration status concerns, Champion suggests culturally tailored outreach and reintroducing Saturday hours to increase accessibility and reduce wait times for those with conflicting work schedules.

Personal stories highlight the impact of Medi-Cal on individuals’ lives. Griselda, a NEVHC patient and mother of three, expresses gratitude for the smooth re-enrollment process, emphasizing the importance of Medi-Cal for her children’s future health.

“My 15 year old daughter had a problem where she couldn’t close her teeth, and she was aware that kids who have this get bullied in school. She was very happy to get braces and prevent that from happening.”

Dara Montejo shares her experience of her undocumented mother’s access to Medi-Cal following a medical emergency, alleviating financial concerns and ensuring proper care.

“Last August, near San Diego, my mother, from Yucatan, had her first seizure. She was undocumented and I didn’t know much about Medi-Cal at the time; I thought she was dying. Even when I was calling the ambulance, in the back of my mind, I thought, ‘How much will the bill be?’ and when the EMTs came, we decided to take her in my dad’s car. I wasn’t feeling safe, but it felt like the only option.”

“As of January, Medi-Cal has now opened its arms to her and I’m not scared of telling her to go to the emergency room whenever she feels bad, because I know we won’t get a bill of thousands of dollars, or over $100 for each bottle of her monthly prescriptions. It’s really nice not having to worry about that anymore.”

Despite improvements, concerns about accessibility gaps and stigma persist. Fitzgerald Graves recounts challenges his daughter faced in navigating Medi-Cal during pregnancy, underscoring the importance of consistent care and support. She pointed out that they kept having to bounce around from clinic to clinic, visiting different doctors. 

Graves acknowledges the progress made in keeping people on Medi-Cal and hopes for continued support in navigating available benefits.

Overall, the efforts to maintain and expand Medi-Cal are seen as positive steps toward improving healthcare accessibility and support in California.