Layoffs: From Unemployment Benefits to Health Insurance, the Steps to Take ASAP
California Will Soon Be First State to Offer Health Insurance to Eligible Undocumented Adults
Over 930,000 Californians Lost Medi-Cal Coverage This Year Due to ‘Procedural Reasons’
Families Fume Over Newsom’s Veto of Children’s Hearing Aid Bill
Gavin Newsom's Mental Health Plan Heads to Voters. Here's What to Know
Feds Grant SF’s Laguna Honda Hospital New Extension, Delaying Involuntary Patient Transfers
Gov. Newsom's Prescription Housing Plan Would Cover 6 Months' Rent Through Medi-Cal
On Medi-Cal? Eligibility Changes Starting in April Could Mean You Lose Coverage. Here's What to Do
California's Massive Medicaid Program Works for Some, but Fails Many Others
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Jump straight to:\u003c/p>\n\u003cul>\n\u003cli>\u003cstrong>\u003ca href=\"#unemploymentbenefits\">Applying for unemployment benefits\u003c/a>\u003c/strong>\u003c/li>\n\u003cli>\u003cstrong>\u003ca href=\"#healthinsurance\">Keeping your health insurance\u003c/a>\u003c/strong>\u003c/li>\n\u003cli>\u003cstrong>\u003ca href=\"#otherbenefits\">Other benefits you might not know you’re eligible for\u003c/a>\u003c/strong>\u003c/li>\n\u003c/ul>\n\u003cp>… Or keep reading. As with the instructions for assembling furniture, you might find it helpful to read all this advice start to finish before you embark on these applications — to be prepared for any bumps you might encounter.\u003c/p>\n\u003ch2>Three tips to making applying for benefits after a layoff easier\u003c/h2>\n\u003cp>\u003cb>Your local government may have staff to help you do this\u003c/b>\u003c/p>\n\u003cp>Many cities and counties have their own offices, staff or programs specifically designed for people in your situation right now — which often have physical offices you can visit, or hotlines to call to ask a person your questions. These kinds of local resources can be particularly helpful in navigating the various benefits you could be entitled to, and aiding in the application processes.\u003c/p>\n\u003cp>Some offices, like the Department of Benefits and Family Support within \u003ca href=\"https://www.sfhsa.org/\">San Francisco’s Human Services Agency (SFHSA)\u003c/a>, can take your information in one central application and apply for those benefits on your behalf.\u003c/p>\n\u003cp>Having the help of a city staffer trained in these applications could save you a lot of time and stress, says Bart Ellison, program manager at SFHSA’s Workforce Development Division — not just because the process is streamlined, but because you’ll be able to ask these folks questions either in person or over the phone. It’s their job to help you — let them do it.\u003c/p>\n\u003cul>\n\u003cli>\u003cstrong>\u003ca href=\"#tellus\">Tell us: What else do you need information about right now?\u003c/a>\u003c/strong>\u003c/li>\n\u003c/ul>\n\u003cp>Your city or county may also have a program to help you find new employment, like \u003ca href=\"https://www.sfhsa.org/services/jobs/jobsnow\">SFHSA’s free JobsNOW! program\u003c/a>, which is open to San Francisco job seekers based on their income level, and matches job hunters with roles.\u003c/p>\n\u003cp>\u003ca href=\"https://www.cdss.ca.gov/county-offices\">Find your local social services office in this statewide list.\u003c/a>\u003c/p>\n\u003cp>\u003cb>Don’t feel weird about claiming the benefits you’re owed\u003c/b>\u003c/p>\n\u003cp>When it comes to claiming benefits after a layoff, Ellison wants to remind you that “we all pay for this through our taxes.”\u003c/p>\n\u003cp>“It’s great that if you don’t need it, it’s there. If you do need it, it’s there, and it should be accessed,” Ellison said. “There’s no shame in any of that.”\u003c/p>\n\u003cp>[aside postID=\"news_11957790,news_11970001,news_11967946,news_11968709\" label=\"COVID Resources and Explainers\"]A lot of people also just don’t know about the benefits they could be eligible for, says Ellison, or assume they won’t qualify.\u003c/p>\n\u003cp>He also says that some of the eligible job seekers he and his team work with in San Francisco might fear coming forward to apply if a member of their family is undocumented, because they think it will cause them problems. “We don’t get involved in any of that,” said Ellison. “They should never fear that situation.”\u003c/p>\n\u003cp>\u003cb>Try to be patient with how long the application process could take\u003c/b>\u003c/p>\n\u003cp>Ellison says he and his team “try not to ask a client for documents that we know we already have in the system” — but concedes that sometimes, this process will feel like providing endless documentation. The benefits you’re applying for can be a mix of federal and state funds, so unfortunately “it’s not just as simple as coming in and saying, ‘Hi, I’m Bart, could you sign me up?,’” said Ellison.\u003c/p>\n\u003cp>The more you can follow through with any documentation requests, hopefully the faster and smoother your application process will go. “And if you need more time or need help gathering stuff, that is what the eligibility staff are there for,” said Ellison. “They are there to \u003ci>help \u003c/i>you find some of these things. So you just need to kind of be your own advocate, and speak up.”\u003c/p>\n\u003cul>\n\u003cli>\u003cstrong>Read more layoff advice in our \u003ca href=\"https://www.kqed.org/news/tag/what-to-do-after-a-layoff\">What to Do After a Layoff \u003c/a>series\u003c/strong>\u003c/li>\n\u003c/ul>\n\u003ch2>\u003ca id=\"unemploymentbenefits\">\u003c/a>Step 1: Apply for unemployment benefits\u003c/h2>\n\u003cp>If you’ve been laid off, \u003ca href=\"https://edd.ca.gov/en/unemployment/apply/\">apply for unemployment insurance\u003c/a> (UI, also known just as “unemployment”) from the California Employment Development Department (EDD) as soon as you can. Not only could it take at least three weeks to receive any benefits payments from a successful claim, but your claim begins when you first apply for it — not the day you lose your job. So time is of the essence.\u003c/p>\n\u003cp>\u003cb>Who can claim unemployment benefits?\u003c/b>\u003c/p>\n\u003cp>If you’re reading this and you \u003ci>chose\u003c/i> to leave your job, you usually aren’t eligible to claim unemployment. The exception to this is if you quit your job for what EDD calls “good cause,” which can include unsafe working conditions or a doctor’s advice. Whether or not you’re eligible to still claim UI in this situation will be determined by a phone interview with an EDD representative.\u003c/p>\n\u003cp>When applying for UI, you’ll have to show EDD that you have earned enough wages during the base period of 12 months, are totally or partially unemployed, are “unemployed through no fault of your own,” are physically able to work, are available for work and are ready and willing to accept work immediately.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>EDD will also ask you to show that you are “in satisfactory immigration status and authorized to work in the United States” not only now, but when you were earning the wages you’re using to establish your claim. EDD also warns that it will verify your immigration status and work authorization through the Department of Homeland Security.\u003c/p>\n\u003cp>You can \u003ca href=\"https://edd.ca.gov/en/unemployment/UI-Calculator/\">calculate the amount of unemployment benefits you can receive using this tool\u003c/a>. Remember that the amount of unemployment you’ll receive is based on your wages over the last 18 months, calculated by EDD from a base period of 12 months within that time — and if you didn’t earn any wages during that period, you won’t qualify for unemployment benefits.\u003c/p>\n\u003cp>\u003ca href=\"https://edd.ca.gov/en/unemployment/FAQ_-_Eligibility/\">See the EDD’s FAQ on who’s eligible to claim unemployment insurance.\u003c/a>\u003c/p>\n\u003cp>\u003cb>Gather your application information\u003c/b>\u003c/p>\n\u003cp>During your online application for UI, you’ll be asked to submit a lot of information — and it’s easiest to have all that gathered and ready, rather than trying to track it down in the middle of the process.\u003c/p>\n\u003cp>In addition to your basic identity information, you’ll need:\u003c/p>\n\u003cul>\n\u003cli>Your Social Security number\u003c/li>\n\u003cli>Your employment authorization information, if you’re not a U.S. citizen\u003c/li>\n\u003cli>A photo ID like a passport or driver’s license (for your ID.me account — more below)\u003c/li>\n\u003c/ul>\n\u003cp>You’ll also need to provide your employment history for the last 18 months, which will include:\u003c/p>\n\u003cul>\n\u003cli>The names of your previous employers\u003c/li>\n\u003cli>Their addresses\u003c/li>\n\u003cli>Their phone numbers\u003c/li>\n\u003cli>The reason each job ended\u003c/li>\n\u003cli>Your gross (total) wages earned\u003c/li>\n\u003cli>Hours worked per week\u003c/li>\n\u003cli>Hourly rate of pay\u003c/li>\n\u003c/ul>\n\u003cfigure id=\"attachment_11946480\" class=\"wp-caption alignnone\" style=\"max-width: 2560px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11946480 size-full\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/04/GettyImages-1400799758-scaled.jpg\" alt=\"A woman sits at her kitchen table and sifts through documents, looking concerned. Next to her is her opened laptop.\" width=\"2560\" height=\"1708\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/04/GettyImages-1400799758-scaled.jpg 2560w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/04/GettyImages-1400799758-800x534.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/04/GettyImages-1400799758-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/04/GettyImages-1400799758-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/04/GettyImages-1400799758-1536x1025.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/04/GettyImages-1400799758-2048x1366.jpg 2048w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/04/GettyImages-1400799758-1920x1281.jpg 1920w\" sizes=\"(max-width: 2560px) 100vw, 2560px\">\u003cfigcaption class=\"wp-caption-text\">During your online application for UI, you’ll be asked to submit a lot of information — and it’s easiest to have all that gathered and ready, rather than trying to track it down in the middle of the process. \u003ccite>(MoMo Productions/Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cb>Make the online accounts you’ll need to apply \u003c/b>\u003c/p>\n\u003cp>To apply for UI for the first time, you’ll need to \u003ca href=\"https://portal.edd.ca.gov/WebApp/Registration\">create a new Benefit Programs Online account\u003c/a>, to enable you to log in and manage your UI claim. (You may already have one of these accounts if you’ve previously applied for UI, disability insurance or paid family leave — in that case, use the same one.)\u003c/p>\n\u003cp>When you give an email address as part of your Benefit Programs Online application, make sure you check for any emails from EDD. When you get an email with a link to complete your registration, make sure you click that link within 48 hours of receiving it — otherwise, you’ll have to start the registration process all over again.\u003c/p>\n\u003cp>When you’ve created your Benefit Programs Online account, \u003ca href=\"https://edd.ca.gov/en/unemployment/ui_online/\">you’ll then register for UI Online\u003c/a>, which is the part of EDD’s online services that allows you to claim and manage your unemployment benefits. Keep reading for how to file your first UI claim.\u003c/p>\n\u003cp>You’ll \u003ci>also\u003c/i> need to \u003ca href=\"https://help.id.me/hc/en-us/articles/202673924-Creating-your-ID-me-account\">have an account with ID.me\u003c/a>, the identity verification EDD uses to make sure you’re really you when you’re claiming benefits. You can create your ID.me account before you create your Benefit Programs Online account, or when prompted during the process of creating it. If you’re creating your ID.me account beforehand, just make sure you keep the login details on hand so that you can sign into ID.me when prompted.\u003c/p>\n\u003cp>You might consider watching the \u003ca href=\"https://www.youtube.com/watch?v=moJ1mokMRgc\">EDD’s short instructional video on YouTube about creating these accounts and filing your first UI claim\u003c/a>, so you know what to expect during the process.\u003c/p>\n\u003cp>\u003cb>File your new UI claim\u003c/b>\u003c/p>\n\u003cp>One big thing: To start using UI Online, you’ll be asked for your “EDD Customer Account Number.” This is a number that’s unique to you, that you can also give instead of your Social Security number on the phone when speaking with an EDD representative. You should receive this number at the preferred email address you gave to EDD — in which case you can start using that EDD Customer Account Number immediately to register for UI Online. It’s also possible to \u003ca href=\"https://edd.ca.gov/en/unemployment/create-account/\">receive this number via mail “10 days after you file your claim,” says EDD\u003c/a>.\u003c/p>\n\u003cp>To file a new claim, \u003ca href=\"https://portal.edd.ca.gov/WebApp/Login?resource_url=https:%2F%2Fportal.edd.ca.gov%2FWebApp%2FHome\">log into your Benefit Programs Online account\u003c/a>, and under “UI Online” select “File New Claim.” Remember you’ll also be asked to briefly sign in to your ID.me account to verify your identity.\u003c/p>\n\u003cp>You can’t apply with UI Online 24/7, unfortunately — \u003ca href=\"https://edd.ca.gov/en/unemployment/ui_online/\">the site has hours of operation\u003c/a> (located on the File and Manage Account tab), which EDD says are currently (all times Pacific Standard Time):\u003c/p>\n\u003cul>\n\u003cli>Sunday: 5 a.m.–8:30 p.m.\u003c/li>\n\u003cli>Monday: 4 a.m.–10 p.m.\u003c/li>\n\u003cli>Tuesday–Friday: 2 a.m.–10 p.m.\u003c/li>\n\u003cli>Saturday: 2 a.m.–8 p.m.\u003c/li>\n\u003c/ul>\n\u003cp>If you need to pause during the UI Online application process, you can hit “Save as draft” to save your application to return to later — unless it’s \u003ci>after \u003c/i>8 p.m. on the Saturday of the week you’ve started the application. If it’s after 8 p.m. on Saturday, or you’re doing this on a Sunday, you won’t be able to save your application, and you will have to start it all over again if you exit.\u003c/p>\n\u003cp>If you’re having issues with UI Online, \u003ca href=\"https://edd.ca.gov/en/unemployment/ui_online/\">EDD recommends that you call their help line\u003c/a> at (833) 978-2511 and select option 1 after the introduction, available 8 a.m.–5 p.m., Monday through Friday. EDD says that Monday morning before 10 a.m. is their busiest call time.\u003c/p>\n\u003cp>\u003cb>Getting — and keeping — your unemployment benefits\u003c/b>\u003c/p>\n\u003cp>Once your application is complete, be aware of \u003ca href=\"https://edd.ca.gov/en/unemployment/After_You_Filed/\">the next steps and further information that EDD will ask of you\u003c/a>.\u003c/p>\n\u003cp>EDD says that \u003ca href=\"https://edd.ca.gov/en/unemployment/After_You_Filed/\">it “takes at least three weeks to process a claim\u003c/a> for unemployment benefits and issue payment to most eligible workers.” You’ll receive a debit card in the mail, which you can activate and then use to access your payments. If you have an old debit card from a previous UI claim, you can still use that one unless it’s expired (in which case you’ll be sent a new one).\u003c/p>\n\u003cp>To keep receiving UI after you first apply, you’ll have to certify for your unemployment benefits again every two weeks to continue receiving payments. You can do this online, by phone or through the mail, but EDD says you’ll get your payments faster if you certify online — and you’ll also get email reminders this way.\u003c/p>\n\u003cp>As part of this certification process every two weeks, you’ll have to \u003ca href=\"https://www.youtube.com/watch?v=3t_RgeoPH_g\">attest that you’re actively seeking employment\u003c/a>. This requirement was paused during the pandemic, but has since been reinstated. You’ll also need to \u003ca href=\"https://edd.ca.gov/en/jobs_and_training/Caljobs/\">register for CalJOBS and post your resume to the site\u003c/a> to keep receiving your UI benefits.\u003c/p>\n\u003cp>If you start doing any work again after losing your job, it’s very important that you report those earnings when you certify for your UI benefits — because those wages have to be deducted from your unemployment benefits. \u003ca href=\"https://edd.ca.gov/en/unemployment/FAQ-claims/#:~:text=Can%20I%20still%20collect%20benefits,deducted%20from%20your%20unemployment%20payments.\">Read more on how EDD will adjust your UI if you start earning money again while claiming unemployment benefits.\u003c/a>\u003c/p>\n\u003cp>And if you’re lucky enough to find a new full-time job, EDD is clear: “If you return to work full time, you will no longer be eligible for unemployment benefits.”\u003c/p>\n\u003cp>\u003ca href=\"https://edd.ca.gov/en/unemployment/certify/\">See EDD’s FAQ on certifying your UI claim every two weeks.\u003c/a>\u003c/p>\n\u003ch2>\u003ca id=\"healthinsurance\">\u003c/a>Step 2: Address your health insurance\u003c/h2>\n\u003cp>If your health insurance was tied to your employment, you need to act swiftly to ensure you’ll still have access to health care after your job ends. The option that’s best for you after your employment ends will depend primarily on how much income your household will now be receiving after you stop working.\u003c/p>\n\u003cp>Remember that if you’ve applied for unemployment benefits, \u003ca href=\"https://www.healthcare.gov/unemployed/\">you’ll need to declare that unemployment compensation as income\u003c/a> when applying for health insurance plans. \u003ca href=\"https://www.healthcare.gov/income-and-household-information/income/\">Get advice on how to estimate your income on your application.\u003c/a>\u003c/p>\n\u003cp>\u003cb>First, check with your employer on when your health benefits will \u003ci>actually\u003c/i> end.\u003c/b>\u003c/p>\n\u003cp>Sometimes a severance package will offer a holdover of benefits, advises the San Francisco’s Human Services Agency’s Bart Ellison. Ask very specific questions of your human resources team, if you have one, about when the last day of your health care will be.\u003c/p>\n\u003cp>\u003cb>See if you can go on a family member’s health care.\u003c/b>\u003c/p>\n\u003cp>Losing your health care because of a job loss will likely qualify as a special enrollment period for joining a family member’s plan, if eligible.\u003c/p>\n\u003cp>If you have a domestic partner, you may be eligible to join their plan. If you’re under 26 years old, \u003ca href=\"https://www.healthcare.gov/young-adults/children-under-26/\">you may be able to join a parent’s plan\u003c/a>.\u003c/p>\n\u003cfigure id=\"attachment_11945872\" class=\"wp-caption alignnone\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11945872 size-full\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/04/pexels-cottonbro-studio-4778412.jpg\" alt=\"A person with medium-toned skin sits at a wooden table writing on a notepad, surrounded by books. They are wearing a gray t-shirt and have tattooed forearms. We can't see their face.\" width=\"1920\" height=\"1280\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/04/pexels-cottonbro-studio-4778412.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/04/pexels-cottonbro-studio-4778412-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/04/pexels-cottonbro-studio-4778412-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/04/pexels-cottonbro-studio-4778412-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/04/pexels-cottonbro-studio-4778412-1536x1024.jpg 1536w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Applying for benefits you’re entitled to can be a time-consuming process. \u003ccite>(cottonbro studio/Pexels)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cb>Medi-Cal\u003c/b>\u003c/p>\n\u003cp>Medi-Cal is California’s version of Medicaid, which offers health care to lower-income folks throughout the state. Eligibility is assessed by your household income, and for many people who qualify, there is no cost of getting health care through Medi-Cal.\u003c/p>\n\u003cp>Laws passed in the last few years in California mean that \u003ca href=\"https://www.dhcs.ca.gov/services/medi-cal/eligibility/Pages/youngadultexp.aspx\">undocumented people age 25 or under\u003c/a> and also \u003ca href=\"https://www.dhcs.ca.gov/services/medi-cal/eligibility/Pages/OlderAdultExpansion.aspx\">undocumented adults age 50 and over\u003c/a> are now eligible to receive Medi-Cal, too.\u003c/p>\n\u003cp>Unlike Covered California, \u003ca href=\"https://www.healthcare.gov/unemployed/\">Medi-Cal has no limited enrollment period\u003c/a> — you can sign up at any time of year if eligible, including if you’ve lost your job. If your children previously were getting health care through your employer’s plan, \u003ca href=\"https://www.insurekidsnow.gov/coverage/ca/index.html\">Medi-Cal — or the Children’s Health Insurance Program — may be able to cover them now\u003c/a>.\u003c/p>\n\u003cp>\u003ca href=\"https://www.dhcs.ca.gov/services/medi-cal/eligibility/Pages/Medi-CalFAQs2014a.aspx#1\">See the state’s FAQ about Medi-Cal.\u003c/a> Medi-Cal and Covered California use the same application portal at \u003ca href=\"https://www.coveredca.com/apply/\">coveredca.com/apply\u003c/a>. Fill out your details, and the site will tell you whether your household income makes you eligible for Medi-Cal or whether you have to choose a private plan from Covered California.\u003c/p>\n\u003cp>\u003cb>Covered California\u003c/b>\u003c/p>\n\u003cp>Covered California is the state’s marketplace that offers private health insurance plans. Depending on your household income, you may qualify for a free or low-cost health plan through Covered California — or you may be eligible to receive financial help through Covered California that could help cover the costs of your premiums and co-pays. As with Medi-Cal, your household income is going to determine what you’re eligible for.\u003c/p>\n\u003cp>Leaving your job for any reason and subsequently \u003ca href=\"https://www.healthcare.gov/unemployed/\">losing your job-based health coverage qualifies for a special enrollment period\u003c/a> for signing up for a marketplace health plan. Usually, you’ll get 60 days from the day you lose your coverage to sign up for a health plan.\u003c/p>\n\u003cp>\u003ca href=\"https://www.dhcs.ca.gov/services/medi-cal/eligibility/Pages/Medi-CalFAQs2014c.aspx#1\">See the state’s FAQ about Covered California.\u003c/a> Remember, Covered California uses the same application portal as Medi-Cal at \u003ca href=\"https://www.coveredca.com/apply/\">coveredca.com/apply\u003c/a>. Fill out your details, and the site will tell you whether your household income makes you eligible for Medi-Cal or whether you have to choose a private plan from Covered California.\u003c/p>\n\u003cp>\u003cb>COBRA\u003c/b>\u003c/p>\n\u003cp>COBRA stands for the federal Consolidated Omnibus Budget Reconciliation Act — and it’s a way of temporarily keeping health care after you leave a job. Instead of opting to sign up for Medi-Cal or a private health insurance plan through Covered California, you can choose so-called “continuation coverage” of your existing health care plan under COBRA, for a certain period of time.\u003c/p>\n\u003cp>\u003ca href=\"https://www.cms.gov/CCIIO/Programs-and-Initiatives/Other-Insurance-Protections/cobra_qna\">Health care through COBRA can be applied retroactively\u003c/a>, if you’re unsure about electing it straightaway. The catch: COBRA is expensive, because it’s the health plan your employer was previously paying part or all of — and now, you’re paying all the costs yourself.\u003c/p>\n\u003cp>\u003cb>Getting back onto health insurance taking a while? Know where your nearest community health center is.\u003c/b>\u003c/p>\n\u003cp>If you aren’t eligible for coverage through Medi-Cal, but signing up for another health plan is proving challenging right now, you can get low-cost health care at a nearby community health center. Make sure you know where your nearest one is, in case you need access to health care quickly. You can \u003ca href=\"https://findahealthcenter.hrsa.gov/\">use this map to find the closest community health center near you\u003c/a>.\u003c/p>\n\u003cp>\u003cb>More resources on finding health care after losing your job:\u003c/b>\u003c/p>\n\u003cul>\n\u003cli>“\u003ca href=\"https://www.coveredca.com/marketing-blog/health-insurance-for-the-unemployed-from-cobra-to-medi-cal/\">Health Insurance for the Unemployed, from COBRA to Medi-Cal\u003c/a>” (from coveredca.com)\u003c/li>\n\u003cli>“\u003ca href=\"https://www.healthcare.gov/unemployed/\">Health coverage options if you’re unemployed\u003c/a>” (from healthcare.gov)\u003c/li>\n\u003c/ul>\n\u003ch2>\u003ca id=\"otherbenefits\">\u003c/a>Step 3: Don’t forget about other benefits you could be entitled to\u003c/h2>\n\u003cp>The quickest way to see what benefits you might be eligible for now is to \u003ca href=\"https://benefitscal.com/ApplyForBenefits/ABOVR\">do one application through the state’s BenefitsCal portal\u003c/a>. This site will review your information and tell you what you may qualify for, including Medi-Cal.\u003c/p>\n\u003cp>The state says this application will take you between 30 minutes and an hour, and if you make an account you can save your progress and return to the application later, rather than having to start again. One catch: Not all counties in California are using this portal yet. \u003ca href=\"https://benefitscal.com/ApplyForBenefits/ABOVR\">Select your county from the drop-down menu\u003c/a> to see whether you have to use another site — \u003ca href=\"https://www.mybenefitscalwin.org/\">mybenefitscalwin.org\u003c/a> — instead.\u003c/p>\n\u003cp>The other benefits you could be entitled to may include:\u003c/p>\n\u003cp>\u003cb>CalFresh (SNAP)\u003c/b>\u003c/p>\n\u003cp>CalFresh is the state’s version of the federal Supplemental Nutrition Assistance Program (SNAP), the food benefits program also known as “food stamps.”\u003c/p>\n\u003cp>[aside postID=\"news_11943420\" hero=\"https://ww2.kqed.org/app/uploads/sites/10/2023/03/GettyImages-1144627849-1020x680.jpg\"]According to the state’s data from March 2023, over 3 million households use these funds to ensure they have access to food. You can \u003ca href=\"https://benefitscal.com/ApplyForBenefits/ABOVR\">apply through benefitscal.com\u003c/a>, which will also show you all other benefits you’re entitled to, or \u003ca href=\"https://www.getcalfresh.org/\">go direct through getcalfresh.org\u003c/a>.\u003c/p>\n\u003cp>\u003cb>CalWORKs (California Work Opportunity and Responsibility to Kids)\u003c/b>\u003c/p>\n\u003cp>If you have at least one child in your home, CalWORKs is a public assistance program that offers cash aid and services to eligible families. \u003ca href=\"https://benefitscal.com/\">See if your family is eligible to receive CalWORKs at benefitscal.com\u003c/a>.\u003c/p>\n\u003cp>\u003cb>WIC (Women, Infants and Children Supplemental Nutrition Program)\u003c/b>\u003c/p>\n\u003cp>WIC provides food assistance to lower-income families who have young children or are expecting a new child. Like CalFresh, it’s federally funded, and you can receive WIC benefits on top of your CalFresh benefits.\u003c/p>\n\u003cp>The program is income-based, and is available to pregnant people, plus new parents and grandparents of young children.\u003ca href=\"https://myfamily.wic.ca.gov/Home/HowCanIGetWIC#howToGetWIC\"> See whether you’re eligible for WIC and apply online.\u003c/a>\u003c/p>\n\u003cp>Make sure to read the rest of our KQED guides about other steps you can take after a layoff to better support yourself and those who depend on you:\u003c/p>\n\u003cul>\n\u003cli>\u003cstrong>\u003ca href=\"https://www.kqed.org/news/11949801/layoffs-how-to-find-a-new-job-jobhunting-tips\">The Best Ways to Find a New Job, According to an Expert\u003c/a>\u003c/strong>\u003c/li>\n\u003cli>\u003cstrong>\u003ca href=\"https://www.kqed.org/news/11949674/layoffs-mental-health-lost-job-self-care\">How to Prioritize Your Mental Health After Losing Your Job, From Telling Family to Self-Care\u003c/a>\u003c/strong>\u003c/li>\n\u003cli>\u003cstrong>\u003ca href=\"https://www.kqed.org/news/11948895/layoffs-how-to-save-more-money-after-losing-your-job\">How to Save More Money After Losing Your Job\u003c/a>\u003c/strong>\u003c/li>\n\u003c/ul>\n\u003ch2>\u003ca id=\"tellus\">\u003c/a>Tell us: What else do you need information about?\u003c/h2>\n\u003cp>At KQED News, we know that it can sometimes be hard to track down the answers to navigate life in the Bay Area. We’ve published \u003ca href=\"https://www.kqed.org/news/tag/coronavirus-resources-and-explainers\">clear, practical explainers and guides about COVID\u003c/a>, \u003ca href=\"https://www.kqed.org/news/11936674/how-to-prepare-for-this-weeks-atmospheric-river-storm-sandbags-emergency-kits-and-more\">how to cope with intense winter weather\u003c/a> and \u003ca href=\"https://www.kqed.org/news/11821950/how-to-safely-attend-a-protest-in-the-bay-area\">how to exercise your right to protest safely\u003c/a>.\u003c/p>\n\u003cp>So tell us: What do you need to know more about? Tell us, and you could see your question answered online or on social media. What you submit will make our reporting stronger, and help us decide what to cover here on our site, and on KQED Public Radio, too.\u003c/p>\n\u003cp>[hearken id=\"10483\" src=\"https://modules.wearehearken.com/kqed/embed/10483.js\"]\u003c/p>\n\u003cp>\u003cem>This story was originally published on May 19, 2023\u003c/em>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n","blocks":[],"excerpt":"Knowing what to do when you get laid off can feel daunting — especially if losing your job came as a shock. Check out our list of the initial steps to take after a layoff, to ensure you’re in as secure a place as possible.","status":"publish","parent":0,"modified":1705007979,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":true,"hasPolis":false,"paragraphCount":89,"wordCount":3722},"headData":{"title":"Layoffs: From Unemployment Benefits to Health Insurance, the Steps to Take ASAP | KQED","description":"Knowing what to do when you get laid off can feel daunting — especially if losing your job came as a shock. Check out our list of the initial steps to take after a layoff, to ensure you’re in as secure a place as possible.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":""},"sticky":false,"excludeFromSiteSearch":"Include","articleAge":"0","path":"/news/11949192/layoffs-unemployment-benefits-health-insurance-calfresh","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cem>This guide is part of the KQED News series \u003cstrong>\u003ca href=\"https://www.kqed.org/news/tag/what-to-do-after-a-layoff\">What to Do After a Layoff.\u003c/a>\u003c/strong>\u003c/em>\u003c/p>\n\u003cp>Knowing what to do when you get laid off can feel like a daunting prospect — especially if losing your job came as a total shock.\u003c/p>\n\u003cp>We’ve compiled a list of the initial steps to take after a layoff, to ensure you’re in as secure a place as possible. Jump straight to:\u003c/p>\n\u003cul>\n\u003cli>\u003cstrong>\u003ca href=\"#unemploymentbenefits\">Applying for unemployment benefits\u003c/a>\u003c/strong>\u003c/li>\n\u003cli>\u003cstrong>\u003ca href=\"#healthinsurance\">Keeping your health insurance\u003c/a>\u003c/strong>\u003c/li>\n\u003cli>\u003cstrong>\u003ca href=\"#otherbenefits\">Other benefits you might not know you’re eligible for\u003c/a>\u003c/strong>\u003c/li>\n\u003c/ul>\n\u003cp>… Or keep reading. As with the instructions for assembling furniture, you might find it helpful to read all this advice start to finish before you embark on these applications — to be prepared for any bumps you might encounter.\u003c/p>\n\u003ch2>Three tips to making applying for benefits after a layoff easier\u003c/h2>\n\u003cp>\u003cb>Your local government may have staff to help you do this\u003c/b>\u003c/p>\n\u003cp>Many cities and counties have their own offices, staff or programs specifically designed for people in your situation right now — which often have physical offices you can visit, or hotlines to call to ask a person your questions. These kinds of local resources can be particularly helpful in navigating the various benefits you could be entitled to, and aiding in the application processes.\u003c/p>\n\u003cp>Some offices, like the Department of Benefits and Family Support within \u003ca href=\"https://www.sfhsa.org/\">San Francisco’s Human Services Agency (SFHSA)\u003c/a>, can take your information in one central application and apply for those benefits on your behalf.\u003c/p>\n\u003cp>Having the help of a city staffer trained in these applications could save you a lot of time and stress, says Bart Ellison, program manager at SFHSA’s Workforce Development Division — not just because the process is streamlined, but because you’ll be able to ask these folks questions either in person or over the phone. It’s their job to help you — let them do it.\u003c/p>\n\u003cul>\n\u003cli>\u003cstrong>\u003ca href=\"#tellus\">Tell us: What else do you need information about right now?\u003c/a>\u003c/strong>\u003c/li>\n\u003c/ul>\n\u003cp>Your city or county may also have a program to help you find new employment, like \u003ca href=\"https://www.sfhsa.org/services/jobs/jobsnow\">SFHSA’s free JobsNOW! program\u003c/a>, which is open to San Francisco job seekers based on their income level, and matches job hunters with roles.\u003c/p>\n\u003cp>\u003ca href=\"https://www.cdss.ca.gov/county-offices\">Find your local social services office in this statewide list.\u003c/a>\u003c/p>\n\u003cp>\u003cb>Don’t feel weird about claiming the benefits you’re owed\u003c/b>\u003c/p>\n\u003cp>When it comes to claiming benefits after a layoff, Ellison wants to remind you that “we all pay for this through our taxes.”\u003c/p>\n\u003cp>“It’s great that if you don’t need it, it’s there. If you do need it, it’s there, and it should be accessed,” Ellison said. “There’s no shame in any of that.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"aside","attributes":{"named":{"postid":"news_11957790,news_11970001,news_11967946,news_11968709","label":"COVID Resources and Explainers "},"numeric":[]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>A lot of people also just don’t know about the benefits they could be eligible for, says Ellison, or assume they won’t qualify.\u003c/p>\n\u003cp>He also says that some of the eligible job seekers he and his team work with in San Francisco might fear coming forward to apply if a member of their family is undocumented, because they think it will cause them problems. “We don’t get involved in any of that,” said Ellison. “They should never fear that situation.”\u003c/p>\n\u003cp>\u003cb>Try to be patient with how long the application process could take\u003c/b>\u003c/p>\n\u003cp>Ellison says he and his team “try not to ask a client for documents that we know we already have in the system” — but concedes that sometimes, this process will feel like providing endless documentation. The benefits you’re applying for can be a mix of federal and state funds, so unfortunately “it’s not just as simple as coming in and saying, ‘Hi, I’m Bart, could you sign me up?,’” said Ellison.\u003c/p>\n\u003cp>The more you can follow through with any documentation requests, hopefully the faster and smoother your application process will go. “And if you need more time or need help gathering stuff, that is what the eligibility staff are there for,” said Ellison. “They are there to \u003ci>help \u003c/i>you find some of these things. So you just need to kind of be your own advocate, and speak up.”\u003c/p>\n\u003cul>\n\u003cli>\u003cstrong>Read more layoff advice in our \u003ca href=\"https://www.kqed.org/news/tag/what-to-do-after-a-layoff\">What to Do After a Layoff \u003c/a>series\u003c/strong>\u003c/li>\n\u003c/ul>\n\u003ch2>\u003ca id=\"unemploymentbenefits\">\u003c/a>Step 1: Apply for unemployment benefits\u003c/h2>\n\u003cp>If you’ve been laid off, \u003ca href=\"https://edd.ca.gov/en/unemployment/apply/\">apply for unemployment insurance\u003c/a> (UI, also known just as “unemployment”) from the California Employment Development Department (EDD) as soon as you can. Not only could it take at least three weeks to receive any benefits payments from a successful claim, but your claim begins when you first apply for it — not the day you lose your job. So time is of the essence.\u003c/p>\n\u003cp>\u003cb>Who can claim unemployment benefits?\u003c/b>\u003c/p>\n\u003cp>If you’re reading this and you \u003ci>chose\u003c/i> to leave your job, you usually aren’t eligible to claim unemployment. The exception to this is if you quit your job for what EDD calls “good cause,” which can include unsafe working conditions or a doctor’s advice. Whether or not you’re eligible to still claim UI in this situation will be determined by a phone interview with an EDD representative.\u003c/p>\n\u003cp>When applying for UI, you’ll have to show EDD that you have earned enough wages during the base period of 12 months, are totally or partially unemployed, are “unemployed through no fault of your own,” are physically able to work, are available for work and are ready and willing to accept work immediately.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>EDD will also ask you to show that you are “in satisfactory immigration status and authorized to work in the United States” not only now, but when you were earning the wages you’re using to establish your claim. EDD also warns that it will verify your immigration status and work authorization through the Department of Homeland Security.\u003c/p>\n\u003cp>You can \u003ca href=\"https://edd.ca.gov/en/unemployment/UI-Calculator/\">calculate the amount of unemployment benefits you can receive using this tool\u003c/a>. Remember that the amount of unemployment you’ll receive is based on your wages over the last 18 months, calculated by EDD from a base period of 12 months within that time — and if you didn’t earn any wages during that period, you won’t qualify for unemployment benefits.\u003c/p>\n\u003cp>\u003ca href=\"https://edd.ca.gov/en/unemployment/FAQ_-_Eligibility/\">See the EDD’s FAQ on who’s eligible to claim unemployment insurance.\u003c/a>\u003c/p>\n\u003cp>\u003cb>Gather your application information\u003c/b>\u003c/p>\n\u003cp>During your online application for UI, you’ll be asked to submit a lot of information — and it’s easiest to have all that gathered and ready, rather than trying to track it down in the middle of the process.\u003c/p>\n\u003cp>In addition to your basic identity information, you’ll need:\u003c/p>\n\u003cul>\n\u003cli>Your Social Security number\u003c/li>\n\u003cli>Your employment authorization information, if you’re not a U.S. citizen\u003c/li>\n\u003cli>A photo ID like a passport or driver’s license (for your ID.me account — more below)\u003c/li>\n\u003c/ul>\n\u003cp>You’ll also need to provide your employment history for the last 18 months, which will include:\u003c/p>\n\u003cul>\n\u003cli>The names of your previous employers\u003c/li>\n\u003cli>Their addresses\u003c/li>\n\u003cli>Their phone numbers\u003c/li>\n\u003cli>The reason each job ended\u003c/li>\n\u003cli>Your gross (total) wages earned\u003c/li>\n\u003cli>Hours worked per week\u003c/li>\n\u003cli>Hourly rate of pay\u003c/li>\n\u003c/ul>\n\u003cfigure id=\"attachment_11946480\" class=\"wp-caption alignnone\" style=\"max-width: 2560px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11946480 size-full\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/04/GettyImages-1400799758-scaled.jpg\" alt=\"A woman sits at her kitchen table and sifts through documents, looking concerned. Next to her is her opened laptop.\" width=\"2560\" height=\"1708\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/04/GettyImages-1400799758-scaled.jpg 2560w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/04/GettyImages-1400799758-800x534.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/04/GettyImages-1400799758-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/04/GettyImages-1400799758-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/04/GettyImages-1400799758-1536x1025.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/04/GettyImages-1400799758-2048x1366.jpg 2048w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/04/GettyImages-1400799758-1920x1281.jpg 1920w\" sizes=\"(max-width: 2560px) 100vw, 2560px\">\u003cfigcaption class=\"wp-caption-text\">During your online application for UI, you’ll be asked to submit a lot of information — and it’s easiest to have all that gathered and ready, rather than trying to track it down in the middle of the process. \u003ccite>(MoMo Productions/Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cb>Make the online accounts you’ll need to apply \u003c/b>\u003c/p>\n\u003cp>To apply for UI for the first time, you’ll need to \u003ca href=\"https://portal.edd.ca.gov/WebApp/Registration\">create a new Benefit Programs Online account\u003c/a>, to enable you to log in and manage your UI claim. (You may already have one of these accounts if you’ve previously applied for UI, disability insurance or paid family leave — in that case, use the same one.)\u003c/p>\n\u003cp>When you give an email address as part of your Benefit Programs Online application, make sure you check for any emails from EDD. When you get an email with a link to complete your registration, make sure you click that link within 48 hours of receiving it — otherwise, you’ll have to start the registration process all over again.\u003c/p>\n\u003cp>When you’ve created your Benefit Programs Online account, \u003ca href=\"https://edd.ca.gov/en/unemployment/ui_online/\">you’ll then register for UI Online\u003c/a>, which is the part of EDD’s online services that allows you to claim and manage your unemployment benefits. Keep reading for how to file your first UI claim.\u003c/p>\n\u003cp>You’ll \u003ci>also\u003c/i> need to \u003ca href=\"https://help.id.me/hc/en-us/articles/202673924-Creating-your-ID-me-account\">have an account with ID.me\u003c/a>, the identity verification EDD uses to make sure you’re really you when you’re claiming benefits. You can create your ID.me account before you create your Benefit Programs Online account, or when prompted during the process of creating it. If you’re creating your ID.me account beforehand, just make sure you keep the login details on hand so that you can sign into ID.me when prompted.\u003c/p>\n\u003cp>You might consider watching the \u003ca href=\"https://www.youtube.com/watch?v=moJ1mokMRgc\">EDD’s short instructional video on YouTube about creating these accounts and filing your first UI claim\u003c/a>, so you know what to expect during the process.\u003c/p>\n\u003cp>\u003cb>File your new UI claim\u003c/b>\u003c/p>\n\u003cp>One big thing: To start using UI Online, you’ll be asked for your “EDD Customer Account Number.” This is a number that’s unique to you, that you can also give instead of your Social Security number on the phone when speaking with an EDD representative. You should receive this number at the preferred email address you gave to EDD — in which case you can start using that EDD Customer Account Number immediately to register for UI Online. It’s also possible to \u003ca href=\"https://edd.ca.gov/en/unemployment/create-account/\">receive this number via mail “10 days after you file your claim,” says EDD\u003c/a>.\u003c/p>\n\u003cp>To file a new claim, \u003ca href=\"https://portal.edd.ca.gov/WebApp/Login?resource_url=https:%2F%2Fportal.edd.ca.gov%2FWebApp%2FHome\">log into your Benefit Programs Online account\u003c/a>, and under “UI Online” select “File New Claim.” Remember you’ll also be asked to briefly sign in to your ID.me account to verify your identity.\u003c/p>\n\u003cp>You can’t apply with UI Online 24/7, unfortunately — \u003ca href=\"https://edd.ca.gov/en/unemployment/ui_online/\">the site has hours of operation\u003c/a> (located on the File and Manage Account tab), which EDD says are currently (all times Pacific Standard Time):\u003c/p>\n\u003cul>\n\u003cli>Sunday: 5 a.m.–8:30 p.m.\u003c/li>\n\u003cli>Monday: 4 a.m.–10 p.m.\u003c/li>\n\u003cli>Tuesday–Friday: 2 a.m.–10 p.m.\u003c/li>\n\u003cli>Saturday: 2 a.m.–8 p.m.\u003c/li>\n\u003c/ul>\n\u003cp>If you need to pause during the UI Online application process, you can hit “Save as draft” to save your application to return to later — unless it’s \u003ci>after \u003c/i>8 p.m. on the Saturday of the week you’ve started the application. If it’s after 8 p.m. on Saturday, or you’re doing this on a Sunday, you won’t be able to save your application, and you will have to start it all over again if you exit.\u003c/p>\n\u003cp>If you’re having issues with UI Online, \u003ca href=\"https://edd.ca.gov/en/unemployment/ui_online/\">EDD recommends that you call their help line\u003c/a> at (833) 978-2511 and select option 1 after the introduction, available 8 a.m.–5 p.m., Monday through Friday. EDD says that Monday morning before 10 a.m. is their busiest call time.\u003c/p>\n\u003cp>\u003cb>Getting — and keeping — your unemployment benefits\u003c/b>\u003c/p>\n\u003cp>Once your application is complete, be aware of \u003ca href=\"https://edd.ca.gov/en/unemployment/After_You_Filed/\">the next steps and further information that EDD will ask of you\u003c/a>.\u003c/p>\n\u003cp>EDD says that \u003ca href=\"https://edd.ca.gov/en/unemployment/After_You_Filed/\">it “takes at least three weeks to process a claim\u003c/a> for unemployment benefits and issue payment to most eligible workers.” You’ll receive a debit card in the mail, which you can activate and then use to access your payments. If you have an old debit card from a previous UI claim, you can still use that one unless it’s expired (in which case you’ll be sent a new one).\u003c/p>\n\u003cp>To keep receiving UI after you first apply, you’ll have to certify for your unemployment benefits again every two weeks to continue receiving payments. You can do this online, by phone or through the mail, but EDD says you’ll get your payments faster if you certify online — and you’ll also get email reminders this way.\u003c/p>\n\u003cp>As part of this certification process every two weeks, you’ll have to \u003ca href=\"https://www.youtube.com/watch?v=3t_RgeoPH_g\">attest that you’re actively seeking employment\u003c/a>. This requirement was paused during the pandemic, but has since been reinstated. You’ll also need to \u003ca href=\"https://edd.ca.gov/en/jobs_and_training/Caljobs/\">register for CalJOBS and post your resume to the site\u003c/a> to keep receiving your UI benefits.\u003c/p>\n\u003cp>If you start doing any work again after losing your job, it’s very important that you report those earnings when you certify for your UI benefits — because those wages have to be deducted from your unemployment benefits. \u003ca href=\"https://edd.ca.gov/en/unemployment/FAQ-claims/#:~:text=Can%20I%20still%20collect%20benefits,deducted%20from%20your%20unemployment%20payments.\">Read more on how EDD will adjust your UI if you start earning money again while claiming unemployment benefits.\u003c/a>\u003c/p>\n\u003cp>And if you’re lucky enough to find a new full-time job, EDD is clear: “If you return to work full time, you will no longer be eligible for unemployment benefits.”\u003c/p>\n\u003cp>\u003ca href=\"https://edd.ca.gov/en/unemployment/certify/\">See EDD’s FAQ on certifying your UI claim every two weeks.\u003c/a>\u003c/p>\n\u003ch2>\u003ca id=\"healthinsurance\">\u003c/a>Step 2: Address your health insurance\u003c/h2>\n\u003cp>If your health insurance was tied to your employment, you need to act swiftly to ensure you’ll still have access to health care after your job ends. The option that’s best for you after your employment ends will depend primarily on how much income your household will now be receiving after you stop working.\u003c/p>\n\u003cp>Remember that if you’ve applied for unemployment benefits, \u003ca href=\"https://www.healthcare.gov/unemployed/\">you’ll need to declare that unemployment compensation as income\u003c/a> when applying for health insurance plans. \u003ca href=\"https://www.healthcare.gov/income-and-household-information/income/\">Get advice on how to estimate your income on your application.\u003c/a>\u003c/p>\n\u003cp>\u003cb>First, check with your employer on when your health benefits will \u003ci>actually\u003c/i> end.\u003c/b>\u003c/p>\n\u003cp>Sometimes a severance package will offer a holdover of benefits, advises the San Francisco’s Human Services Agency’s Bart Ellison. Ask very specific questions of your human resources team, if you have one, about when the last day of your health care will be.\u003c/p>\n\u003cp>\u003cb>See if you can go on a family member’s health care.\u003c/b>\u003c/p>\n\u003cp>Losing your health care because of a job loss will likely qualify as a special enrollment period for joining a family member’s plan, if eligible.\u003c/p>\n\u003cp>If you have a domestic partner, you may be eligible to join their plan. If you’re under 26 years old, \u003ca href=\"https://www.healthcare.gov/young-adults/children-under-26/\">you may be able to join a parent’s plan\u003c/a>.\u003c/p>\n\u003cfigure id=\"attachment_11945872\" class=\"wp-caption alignnone\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11945872 size-full\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/04/pexels-cottonbro-studio-4778412.jpg\" alt=\"A person with medium-toned skin sits at a wooden table writing on a notepad, surrounded by books. They are wearing a gray t-shirt and have tattooed forearms. We can't see their face.\" width=\"1920\" height=\"1280\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/04/pexels-cottonbro-studio-4778412.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/04/pexels-cottonbro-studio-4778412-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/04/pexels-cottonbro-studio-4778412-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/04/pexels-cottonbro-studio-4778412-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/04/pexels-cottonbro-studio-4778412-1536x1024.jpg 1536w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Applying for benefits you’re entitled to can be a time-consuming process. \u003ccite>(cottonbro studio/Pexels)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cb>Medi-Cal\u003c/b>\u003c/p>\n\u003cp>Medi-Cal is California’s version of Medicaid, which offers health care to lower-income folks throughout the state. Eligibility is assessed by your household income, and for many people who qualify, there is no cost of getting health care through Medi-Cal.\u003c/p>\n\u003cp>Laws passed in the last few years in California mean that \u003ca href=\"https://www.dhcs.ca.gov/services/medi-cal/eligibility/Pages/youngadultexp.aspx\">undocumented people age 25 or under\u003c/a> and also \u003ca href=\"https://www.dhcs.ca.gov/services/medi-cal/eligibility/Pages/OlderAdultExpansion.aspx\">undocumented adults age 50 and over\u003c/a> are now eligible to receive Medi-Cal, too.\u003c/p>\n\u003cp>Unlike Covered California, \u003ca href=\"https://www.healthcare.gov/unemployed/\">Medi-Cal has no limited enrollment period\u003c/a> — you can sign up at any time of year if eligible, including if you’ve lost your job. If your children previously were getting health care through your employer’s plan, \u003ca href=\"https://www.insurekidsnow.gov/coverage/ca/index.html\">Medi-Cal — or the Children’s Health Insurance Program — may be able to cover them now\u003c/a>.\u003c/p>\n\u003cp>\u003ca href=\"https://www.dhcs.ca.gov/services/medi-cal/eligibility/Pages/Medi-CalFAQs2014a.aspx#1\">See the state’s FAQ about Medi-Cal.\u003c/a> Medi-Cal and Covered California use the same application portal at \u003ca href=\"https://www.coveredca.com/apply/\">coveredca.com/apply\u003c/a>. Fill out your details, and the site will tell you whether your household income makes you eligible for Medi-Cal or whether you have to choose a private plan from Covered California.\u003c/p>\n\u003cp>\u003cb>Covered California\u003c/b>\u003c/p>\n\u003cp>Covered California is the state’s marketplace that offers private health insurance plans. Depending on your household income, you may qualify for a free or low-cost health plan through Covered California — or you may be eligible to receive financial help through Covered California that could help cover the costs of your premiums and co-pays. As with Medi-Cal, your household income is going to determine what you’re eligible for.\u003c/p>\n\u003cp>Leaving your job for any reason and subsequently \u003ca href=\"https://www.healthcare.gov/unemployed/\">losing your job-based health coverage qualifies for a special enrollment period\u003c/a> for signing up for a marketplace health plan. Usually, you’ll get 60 days from the day you lose your coverage to sign up for a health plan.\u003c/p>\n\u003cp>\u003ca href=\"https://www.dhcs.ca.gov/services/medi-cal/eligibility/Pages/Medi-CalFAQs2014c.aspx#1\">See the state’s FAQ about Covered California.\u003c/a> Remember, Covered California uses the same application portal as Medi-Cal at \u003ca href=\"https://www.coveredca.com/apply/\">coveredca.com/apply\u003c/a>. Fill out your details, and the site will tell you whether your household income makes you eligible for Medi-Cal or whether you have to choose a private plan from Covered California.\u003c/p>\n\u003cp>\u003cb>COBRA\u003c/b>\u003c/p>\n\u003cp>COBRA stands for the federal Consolidated Omnibus Budget Reconciliation Act — and it’s a way of temporarily keeping health care after you leave a job. Instead of opting to sign up for Medi-Cal or a private health insurance plan through Covered California, you can choose so-called “continuation coverage” of your existing health care plan under COBRA, for a certain period of time.\u003c/p>\n\u003cp>\u003ca href=\"https://www.cms.gov/CCIIO/Programs-and-Initiatives/Other-Insurance-Protections/cobra_qna\">Health care through COBRA can be applied retroactively\u003c/a>, if you’re unsure about electing it straightaway. The catch: COBRA is expensive, because it’s the health plan your employer was previously paying part or all of — and now, you’re paying all the costs yourself.\u003c/p>\n\u003cp>\u003cb>Getting back onto health insurance taking a while? Know where your nearest community health center is.\u003c/b>\u003c/p>\n\u003cp>If you aren’t eligible for coverage through Medi-Cal, but signing up for another health plan is proving challenging right now, you can get low-cost health care at a nearby community health center. Make sure you know where your nearest one is, in case you need access to health care quickly. You can \u003ca href=\"https://findahealthcenter.hrsa.gov/\">use this map to find the closest community health center near you\u003c/a>.\u003c/p>\n\u003cp>\u003cb>More resources on finding health care after losing your job:\u003c/b>\u003c/p>\n\u003cul>\n\u003cli>“\u003ca href=\"https://www.coveredca.com/marketing-blog/health-insurance-for-the-unemployed-from-cobra-to-medi-cal/\">Health Insurance for the Unemployed, from COBRA to Medi-Cal\u003c/a>” (from coveredca.com)\u003c/li>\n\u003cli>“\u003ca href=\"https://www.healthcare.gov/unemployed/\">Health coverage options if you’re unemployed\u003c/a>” (from healthcare.gov)\u003c/li>\n\u003c/ul>\n\u003ch2>\u003ca id=\"otherbenefits\">\u003c/a>Step 3: Don’t forget about other benefits you could be entitled to\u003c/h2>\n\u003cp>The quickest way to see what benefits you might be eligible for now is to \u003ca href=\"https://benefitscal.com/ApplyForBenefits/ABOVR\">do one application through the state’s BenefitsCal portal\u003c/a>. This site will review your information and tell you what you may qualify for, including Medi-Cal.\u003c/p>\n\u003cp>The state says this application will take you between 30 minutes and an hour, and if you make an account you can save your progress and return to the application later, rather than having to start again. One catch: Not all counties in California are using this portal yet. \u003ca href=\"https://benefitscal.com/ApplyForBenefits/ABOVR\">Select your county from the drop-down menu\u003c/a> to see whether you have to use another site — \u003ca href=\"https://www.mybenefitscalwin.org/\">mybenefitscalwin.org\u003c/a> — instead.\u003c/p>\n\u003cp>The other benefits you could be entitled to may include:\u003c/p>\n\u003cp>\u003cb>CalFresh (SNAP)\u003c/b>\u003c/p>\n\u003cp>CalFresh is the state’s version of the federal Supplemental Nutrition Assistance Program (SNAP), the food benefits program also known as “food stamps.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"aside","attributes":{"named":{"postid":"news_11943420","hero":"https://ww2.kqed.org/app/uploads/sites/10/2023/03/GettyImages-1144627849-1020x680.jpg","label":""},"numeric":[]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>According to the state’s data from March 2023, over 3 million households use these funds to ensure they have access to food. You can \u003ca href=\"https://benefitscal.com/ApplyForBenefits/ABOVR\">apply through benefitscal.com\u003c/a>, which will also show you all other benefits you’re entitled to, or \u003ca href=\"https://www.getcalfresh.org/\">go direct through getcalfresh.org\u003c/a>.\u003c/p>\n\u003cp>\u003cb>CalWORKs (California Work Opportunity and Responsibility to Kids)\u003c/b>\u003c/p>\n\u003cp>If you have at least one child in your home, CalWORKs is a public assistance program that offers cash aid and services to eligible families. \u003ca href=\"https://benefitscal.com/\">See if your family is eligible to receive CalWORKs at benefitscal.com\u003c/a>.\u003c/p>\n\u003cp>\u003cb>WIC (Women, Infants and Children Supplemental Nutrition Program)\u003c/b>\u003c/p>\n\u003cp>WIC provides food assistance to lower-income families who have young children or are expecting a new child. Like CalFresh, it’s federally funded, and you can receive WIC benefits on top of your CalFresh benefits.\u003c/p>\n\u003cp>The program is income-based, and is available to pregnant people, plus new parents and grandparents of young children.\u003ca href=\"https://myfamily.wic.ca.gov/Home/HowCanIGetWIC#howToGetWIC\"> See whether you’re eligible for WIC and apply online.\u003c/a>\u003c/p>\n\u003cp>Make sure to read the rest of our KQED guides about other steps you can take after a layoff to better support yourself and those who depend on you:\u003c/p>\n\u003cul>\n\u003cli>\u003cstrong>\u003ca href=\"https://www.kqed.org/news/11949801/layoffs-how-to-find-a-new-job-jobhunting-tips\">The Best Ways to Find a New Job, According to an Expert\u003c/a>\u003c/strong>\u003c/li>\n\u003cli>\u003cstrong>\u003ca href=\"https://www.kqed.org/news/11949674/layoffs-mental-health-lost-job-self-care\">How to Prioritize Your Mental Health After Losing Your Job, From Telling Family to Self-Care\u003c/a>\u003c/strong>\u003c/li>\n\u003cli>\u003cstrong>\u003ca href=\"https://www.kqed.org/news/11948895/layoffs-how-to-save-more-money-after-losing-your-job\">How to Save More Money After Losing Your Job\u003c/a>\u003c/strong>\u003c/li>\n\u003c/ul>\n\u003ch2>\u003ca id=\"tellus\">\u003c/a>Tell us: What else do you need information about?\u003c/h2>\n\u003cp>At KQED News, we know that it can sometimes be hard to track down the answers to navigate life in the Bay Area. We’ve published \u003ca href=\"https://www.kqed.org/news/tag/coronavirus-resources-and-explainers\">clear, practical explainers and guides about COVID\u003c/a>, \u003ca href=\"https://www.kqed.org/news/11936674/how-to-prepare-for-this-weeks-atmospheric-river-storm-sandbags-emergency-kits-and-more\">how to cope with intense winter weather\u003c/a> and \u003ca href=\"https://www.kqed.org/news/11821950/how-to-safely-attend-a-protest-in-the-bay-area\">how to exercise your right to protest safely\u003c/a>.\u003c/p>\n\u003cp>So tell us: What do you need to know more about? Tell us, and you could see your question answered online or on social media. What you submit will make our reporting stronger, and help us decide what to cover here on our site, and on KQED Public Radio, too.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"hearken","attributes":{"named":{"id":"10483","src":"https://modules.wearehearken.com/kqed/embed/10483.js","label":""},"numeric":[]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>This story was originally published on May 19, 2023\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/news/11949192/layoffs-unemployment-benefits-health-insurance-calfresh","authors":["3243"],"categories":["news_8"],"tags":["news_32707","news_5164","news_28339","news_31848","news_27626","news_1054","news_352","news_32053","news_2605","news_28004","news_631","news_30130","news_32735"],"featImg":"news_11949742","label":"news"},"news_11971102":{"type":"posts","id":"news_11971102","meta":{"index":"posts_1591205157","site":"news","id":"11971102","score":null,"sort":[1703880035000]},"guestAuthors":[],"slug":"california-becomes-first-state-to-offer-health-insurance-to-all-eligible-undocumented-adults","title":"California Will Soon Be First State to Offer Health Insurance to Eligible Undocumented Adults","publishDate":1703880035,"format":"standard","headTitle":"California Will Soon Be First State to Offer Health Insurance to Eligible Undocumented Adults | KQED","labelTerm":{"term":18481,"site":"news"},"content":"\u003cp>\u003cem>Lea este artículo en \u003ca href=\"https://calmatters.org/calmatters-en-espanol/2023/12/california-se-convierte-en-el-primer-estado-en-ofrecer-seguro-medico-a-todos-los-adultos-indocumentados-elegibles/\">español\u003c/a>.\u003c/em>\u003c/p>\n\u003cp>Perla Lopez hands a stack of papers to Baudeilio, a 44-year-old undocumented immigrant and day laborer. She has just helped him apply for Medi-Cal at the benefits center at St. John’s Community Health in South Los Angeles.\u003c/p>\n\u003cp>“If you see anything you don’t understand from the county, come back here,” Lopez tells Baudeilio in Spanish.\u003c/p>\n\u003cp>The application takes less than 20 minutes. The paperwork, though brief, marks a major milestone in California’s decades-long expansion of health care for undocumented immigrants.\u003c/p>\n\u003cp>Beginning Jan. 1, for the first time, undocumented immigrants of all ages will qualify for Medi-Cal, the state’s health insurance program for extremely low-income people. It makes \u003ca href=\"https://www.kff.org/racial-equity-and-health-policy/fact-sheet/key-facts-on-health-coverage-of-immigrants/\" target=\"_blank\" rel=\"noreferrer noopener\">California the only state\u003c/a> to fund comprehensive health care for undocumented immigrants.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Baudeilio, who has been denied coverage before and asked that his last name not be published to protect him from immigration authorities, will join more than 700,000 undocumented immigrants between the ages of 26 and 49 who will become eligible for Medi-Cal as part of the state’s final expansion of the program — the realization of a long-awaited dream for Californians without legal status.\u003c/p>\n\u003cp>“This is the culmination of literally decades of work, and it’s huge,” said Sarah Dar, policy director for the California Immigrant Policy Center. “It’s huge because of all the work and effort and advocacy that went into making this possible, and it’s also huge because of the impact that it’s going to have.”\u003c/p>\n\u003cp>Gov. Gavin Newsom and the state’s Democratic-led Legislature have committed more than $4 billion annually to the Medi-Cal expansion. \u003ca href=\"https://ebudget.ca.gov/2022-23/pdf/Enacted/BudgetSummary/HealthandHumanServices.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">Newsom’s 2022 budget\u003c/a> made the latest expansion possible, and though the state is now headed into a \u003ca href=\"https://calmatters.org/politics/2023/12/budget-deficit-california/\" target=\"_blank\" rel=\"noreferrer noopener\">$68 billion deficit\u003c/a>, advocates said the positive impact Medi-Cal will have on individual health is priceless.[aside label=\"more Medi-cal-coverage\" tag=\"medi-cal\"]The change resonates deeply with Lopez, who is herself undocumented and eligible to work through the Deferred Action for Childhood Arrivals program.\u003c/p>\n\u003cp>Last year, when the state \u003ca href=\"https://calmatters.org/health/2022/02/medi-cal-expansion-immigrants/\" target=\"_blank\" rel=\"noreferrer noopener\">expanded Medi-Cal to older immigrants over 50\u003c/a>, Lopez’s mother was finally able to get medication and blood testing equipment for her diabetes. This year, surrounded by tinsel and other Christmas decorations in her brightly lit office, Lopez is happy she gets to deliver good news to undocumented patients.\u003c/p>\n\u003cp>“It really touches me,” she said. “It’s a stressor we take away from them. … For people with health issues, Medi-Cal really makes a difference.”\u003c/p>\n\u003cp>The clinic where Lopez works estimates about 13,000 of its patients will become eligible for Medi-Cal in the new year. They’re part of the largest group in California’s ambitious plan to close the insurance gap. Los Angeles County alone accounts for roughly half of the enrollees who are expected to qualify for Medi-Cal.\u003c/p>\n\u003cp>“It’s an exciting moment for our patients as well as for us,” said Annie Uraga, benefits counselor coordinator at St. John’s Community Health. “They’re ready. Many of them are in need or waiting for specialist visits.”\u003c/p>\n\u003ch2>California’s health insurance expansion\u003c/h2>\n\u003cp>The final expansion comes nine years after then-Gov. Jerry Brown signed the 2015 law making undocumented children eligible for state insurance, and it is due to the efforts of advocates trekking to the Capitol to plead their case.\u003c/p>\n\u003cp>“When we talk to people who are impacted by this, the difference it makes in their lives is something that truly numbers and words cannot even describe,” Dar, with the California Immigrant Policy Center, said. “In many cases, people have lived for decades without any kind of health care whatsoever.”\u003c/p>\n\u003cp>Full-scope Medi-Cal, which offers access to primary and preventive care, specialists, pharmaceuticals, and other wraparound services, will change lives, Dar said. California does not share immigration information with federal authorities, and enrolling in Medi-Cal will not threaten chances to pursue legal residency.\u003c/p>\n\u003cp>The California Immigrant Policy Center and consumer advocacy group Health Access California have been the leading force in the campaign to eliminate citizenship requirements for Medi-Cal. The work was not easy, even in left-leaning California. Many moderate Democrats voted against the legislation or refrained from weighing in on the debate in the early days, Dar said, but slowly, public opinion and political will shifted.\u003c/p>\n\u003cp>About \u003ca href=\"https://www.ppic.org/publication/immigrants-and-health-in-california/\" target=\"_blank\" rel=\"noreferrer noopener\">66% of California adults supported health coverage\u003c/a> for undocumented immigrants in March 2021, up from 54% in 2015, according to a survey by the Public Policy Institute of California.\u003c/p>\n\u003cp>\u003ca href=\"https://www.sacbee.com/news/politics-government/article239976023.html\" target=\"_blank\" rel=\"noreferrer noopener\">Former Republican President Donald Trump\u003c/a> lambasted California’s expansion for young adults in 2020 and claimed California and other states would “bankrupt our nation by providing free taxpayer-funded health care to millions of illegal aliens.” California Republican leaders, though less harsh in their condemnation of the state’s immigration policies in recent years, have \u003ca href=\"https://src.senate.ca.gov/content/highlights-and-analysis-2022-23-governors-budget\" target=\"_blank\" rel=\"noreferrer noopener\">accused Newsom of overloading the state’s budget\u003c/a> and Medi-Cal system.\u003c/p>\n\u003cp>“Medi-Cal is already strained by serving 14.6 million Californians —more than a third of the state’s population. Adding 764,000 more individuals to the system will certainly exacerbate current provider access problems,” the Senate Republican Caucus said in a January 2022 budget analysis.\u003c/p>\n\u003cp>For his part, Newsom has played a critical role in propelling the movement forward, said Rachel Linn Gish, communications director for Health Access California. Newsom, who took office in 2019, campaigned on the \u003ca href=\"https://www.politico.com/states/california/story/2018/11/29/how-newsoms-big-win-gives-him-a-mandate-on-health-care-715530\" target=\"_blank\" rel=\"noreferrer noopener\">promise of establishing universal health care in California\u003c/a>, and advocates have spent the duration of his governorship pushing him to keep that promise.[pullquote align=\"right\" size=\"medium\" citation=\"Rachel Linn Gish, Health Access California\"]‘You cannot talk about coverage for all if you’re not talking about coverage for everyone regardless of their immigration status.’[/pullquote]“You cannot talk about coverage for all if you’re not talking about coverage for everyone regardless of their immigration status,” Linn Gish said. “Gov. Newsom made it a major platform of his from day one, and I think it’s hard to untie those two things.”\u003c/p>\n\u003cp>Newsom has faced pressure to do more for undocumented immigrants and to do it faster. Advocates and some legislators lobbied Newsom to roll out this last expansion sooner, in part because of the \u003ca href=\"https://calmatters.org/california-divide/2022/01/omicron-essential-workers-alone/\" target=\"_blank\" rel=\"noreferrer noopener\">disproportionate toll COVID-19 took on essential workers\u003c/a>, many of whom are undocumented.\u003c/p>\n\u003cp>This expansion is \u003ca href=\"https://ebudget.ca.gov/2022-23/pdf/Enacted/BudgetSummary/HealthandHumanServices.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">projected to cost\u003c/a> more than $835 million in the next six months and $2.6 billion every year after that. Previous expansions, which opened the door to more than 1.1 million undocumented enrollees, cost the state approximately $1.6 billion annually, according to \u003ca href=\"https://lao.ca.gov/Publications/Report/4423\" target=\"_blank\" rel=\"noreferrer noopener\">past Legislative Analyst’s Office reports\u003c/a>. The total $4 billion price tag, though significant, represents a fraction of Medi-Cal’s expansive $37 billion budget.\u003c/p>\n\u003cp>Still, many \u003ca href=\"https://calmatters.org/health/2022/02/medi-cal-expansion-immigrants/\" target=\"_blank\" rel=\"noreferrer noopener\">undocumented Californians will remain ineligible\u003c/a>\u003ca href=\"https://calmatters.org/health/2022/02/medi-cal-expansion-immigrants/\"> for health insurance\u003c/a>. Roughly half a million immigrants make too much money to qualify for Medi-Cal but still can’t afford private insurance. Advocates want to expand Covered California to include that population, but the state’s ballooning deficit makes that unlikely in the near future.\u003c/p>\n\u003ch2>Health disparities among undocumented immigrants\u003c/h2>\n\u003cp>Many undocumented immigrants avoid medical care, making it difficult to compare their health to other California residents. Some studies indicate they experience \u003ca href=\"https://www.ppic.org/publication/health-conditions-and-health-care-among-californias-undocumented-immigrants/\">higher rates of chronic conditions\u003c/a> like heart disease, asthma and high blood pressure. Immigrants without legal status in California are also \u003ca href=\"https://link.springer.com/article/10.1007/s11113-021-09689-w\">more likely to suffer from \u003c/a>\u003ca href=\"https://link.springer.com/article/10.1007/s11113-021-09689-w\" target=\"_blank\" rel=\"noreferrer noopener\">mental\u003c/a>\u003ca href=\"https://link.springer.com/article/10.1007/s11113-021-09689-w\"> distress and self-report poor health\u003c/a>.\u003c/p>\n\u003cp>Dr. Efrain Talamantes, chief operating officer at AltaMed in Los Angeles, the largest federally qualified health center in California, said he frequently sees young, undocumented individuals who feel healthy but “already are having the end damage of chronic conditions that have not been detected.”\u003c/p>\n\u003cp>The new Medi-Cal expansion will allow Talamantes and others who serve undocumented communities to give patients affordable, high-level care. Although California offers many undocumented immigrants emergency Medi-Cal, and \u003ca href=\"https://dhs.lacounty.gov/my-health-la/\">some counties fund their own programs\u003c/a>, services can be disjointed with monthslong wait times.\u003c/p>\n\u003cp>“When these patients now receive Medi-Cal and are part of a managed care health care plan with us, then we’re responsible for their entire care from primary and specialty to hospital care,” Talamantes said.\u003c/p>\n\u003cp>Miriam Pozuelos is one such potential beneficiary. The Los Angeles-area mother said the expansion lifts a huge financial burden from her family. She and her husband now pay out-of-pocket for any medical services and often go without. Both have already applied to full-scope Medi-Cal for January.\u003c/p>\n\u003cp>“When me and my family heard about this expansion, we were just really hoping that it would actually come true and that we can start getting the care that we need and not be worried about ‘I have to pay this enormous bill,’” Pozuelos said in Spanish.\u003c/p>\n\u003cp>Back at the St. John’s Community Health benefits center, Lopez helps another undocumented immigrant renew his emergency Medi-Cal, which will automatically roll over to full-scope next month. Wilder, 41, who requested his last name be withheld to protect him from immigration authorities, said he needs two root canals totaling $8,000. He has searched for months for a cheaper option without success, he said. He also needs medication for high blood pressure but can’t always afford it.\u003c/p>\n\u003cp>The Medi-Cal expansion means he’ll finally be able to take care of his health, Wilder said.\u003c/p>\n\u003cp>“It’s nice seeing them leaving happy and smiling,” Lopez said. “Even if it takes us three hours, they leave with a sense of relief that they can see the doctor.”\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>Supported by the California Health Care Foundation (CHCF), which works to ensure that\u003c/em> \u003cem>people have access to the care they need, when they need it, at a price they can afford. Visit \u003c/em>\u003ca href=\"http://www.chcf.org/\">\u003cem>www.chcf.org\u003c/em>\u003c/a>\u003cem> to learn more.\u003c/em>\u003c/p>\n\n","blocks":[],"excerpt":"Beginning Jan. 1, undocumented immigrants of all ages will qualify for Medi-Cal, the state's health insurance program for people with extremely low-income.","status":"publish","parent":0,"modified":1703884900,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":35,"wordCount":1737},"headData":{"title":"California Will Soon Be First State to Offer Health Insurance to Eligible Undocumented Adults | KQED","description":"Beginning Jan. 1, undocumented immigrants of all ages will qualify for Medi-Cal, the state's health insurance program for people with extremely low-income.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":""},"sticky":false,"nprByline":"\u003ca href=\"https://calmatters.org/author/kristen-hwang/\">Kristen Hwang\u003c/a>","excludeFromSiteSearch":"Include","showOnAuthorArchivePages":"No","articleAge":"0","path":"/news/11971102/california-becomes-first-state-to-offer-health-insurance-to-all-eligible-undocumented-adults","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cem>Lea este artículo en \u003ca href=\"https://calmatters.org/calmatters-en-espanol/2023/12/california-se-convierte-en-el-primer-estado-en-ofrecer-seguro-medico-a-todos-los-adultos-indocumentados-elegibles/\">español\u003c/a>.\u003c/em>\u003c/p>\n\u003cp>Perla Lopez hands a stack of papers to Baudeilio, a 44-year-old undocumented immigrant and day laborer. She has just helped him apply for Medi-Cal at the benefits center at St. John’s Community Health in South Los Angeles.\u003c/p>\n\u003cp>“If you see anything you don’t understand from the county, come back here,” Lopez tells Baudeilio in Spanish.\u003c/p>\n\u003cp>The application takes less than 20 minutes. The paperwork, though brief, marks a major milestone in California’s decades-long expansion of health care for undocumented immigrants.\u003c/p>\n\u003cp>Beginning Jan. 1, for the first time, undocumented immigrants of all ages will qualify for Medi-Cal, the state’s health insurance program for extremely low-income people. It makes \u003ca href=\"https://www.kff.org/racial-equity-and-health-policy/fact-sheet/key-facts-on-health-coverage-of-immigrants/\" target=\"_blank\" rel=\"noreferrer noopener\">California the only state\u003c/a> to fund comprehensive health care for undocumented immigrants.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Baudeilio, who has been denied coverage before and asked that his last name not be published to protect him from immigration authorities, will join more than 700,000 undocumented immigrants between the ages of 26 and 49 who will become eligible for Medi-Cal as part of the state’s final expansion of the program — the realization of a long-awaited dream for Californians without legal status.\u003c/p>\n\u003cp>“This is the culmination of literally decades of work, and it’s huge,” said Sarah Dar, policy director for the California Immigrant Policy Center. “It’s huge because of all the work and effort and advocacy that went into making this possible, and it’s also huge because of the impact that it’s going to have.”\u003c/p>\n\u003cp>Gov. Gavin Newsom and the state’s Democratic-led Legislature have committed more than $4 billion annually to the Medi-Cal expansion. \u003ca href=\"https://ebudget.ca.gov/2022-23/pdf/Enacted/BudgetSummary/HealthandHumanServices.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">Newsom’s 2022 budget\u003c/a> made the latest expansion possible, and though the state is now headed into a \u003ca href=\"https://calmatters.org/politics/2023/12/budget-deficit-california/\" target=\"_blank\" rel=\"noreferrer noopener\">$68 billion deficit\u003c/a>, advocates said the positive impact Medi-Cal will have on individual health is priceless.\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"aside","attributes":{"named":{"label":"more Medi-cal-coverage ","tag":"medi-cal"},"numeric":[]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>The change resonates deeply with Lopez, who is herself undocumented and eligible to work through the Deferred Action for Childhood Arrivals program.\u003c/p>\n\u003cp>Last year, when the state \u003ca href=\"https://calmatters.org/health/2022/02/medi-cal-expansion-immigrants/\" target=\"_blank\" rel=\"noreferrer noopener\">expanded Medi-Cal to older immigrants over 50\u003c/a>, Lopez’s mother was finally able to get medication and blood testing equipment for her diabetes. This year, surrounded by tinsel and other Christmas decorations in her brightly lit office, Lopez is happy she gets to deliver good news to undocumented patients.\u003c/p>\n\u003cp>“It really touches me,” she said. “It’s a stressor we take away from them. … For people with health issues, Medi-Cal really makes a difference.”\u003c/p>\n\u003cp>The clinic where Lopez works estimates about 13,000 of its patients will become eligible for Medi-Cal in the new year. They’re part of the largest group in California’s ambitious plan to close the insurance gap. Los Angeles County alone accounts for roughly half of the enrollees who are expected to qualify for Medi-Cal.\u003c/p>\n\u003cp>“It’s an exciting moment for our patients as well as for us,” said Annie Uraga, benefits counselor coordinator at St. John’s Community Health. “They’re ready. Many of them are in need or waiting for specialist visits.”\u003c/p>\n\u003ch2>California’s health insurance expansion\u003c/h2>\n\u003cp>The final expansion comes nine years after then-Gov. Jerry Brown signed the 2015 law making undocumented children eligible for state insurance, and it is due to the efforts of advocates trekking to the Capitol to plead their case.\u003c/p>\n\u003cp>“When we talk to people who are impacted by this, the difference it makes in their lives is something that truly numbers and words cannot even describe,” Dar, with the California Immigrant Policy Center, said. “In many cases, people have lived for decades without any kind of health care whatsoever.”\u003c/p>\n\u003cp>Full-scope Medi-Cal, which offers access to primary and preventive care, specialists, pharmaceuticals, and other wraparound services, will change lives, Dar said. California does not share immigration information with federal authorities, and enrolling in Medi-Cal will not threaten chances to pursue legal residency.\u003c/p>\n\u003cp>The California Immigrant Policy Center and consumer advocacy group Health Access California have been the leading force in the campaign to eliminate citizenship requirements for Medi-Cal. The work was not easy, even in left-leaning California. Many moderate Democrats voted against the legislation or refrained from weighing in on the debate in the early days, Dar said, but slowly, public opinion and political will shifted.\u003c/p>\n\u003cp>About \u003ca href=\"https://www.ppic.org/publication/immigrants-and-health-in-california/\" target=\"_blank\" rel=\"noreferrer noopener\">66% of California adults supported health coverage\u003c/a> for undocumented immigrants in March 2021, up from 54% in 2015, according to a survey by the Public Policy Institute of California.\u003c/p>\n\u003cp>\u003ca href=\"https://www.sacbee.com/news/politics-government/article239976023.html\" target=\"_blank\" rel=\"noreferrer noopener\">Former Republican President Donald Trump\u003c/a> lambasted California’s expansion for young adults in 2020 and claimed California and other states would “bankrupt our nation by providing free taxpayer-funded health care to millions of illegal aliens.” California Republican leaders, though less harsh in their condemnation of the state’s immigration policies in recent years, have \u003ca href=\"https://src.senate.ca.gov/content/highlights-and-analysis-2022-23-governors-budget\" target=\"_blank\" rel=\"noreferrer noopener\">accused Newsom of overloading the state’s budget\u003c/a> and Medi-Cal system.\u003c/p>\n\u003cp>“Medi-Cal is already strained by serving 14.6 million Californians —more than a third of the state’s population. Adding 764,000 more individuals to the system will certainly exacerbate current provider access problems,” the Senate Republican Caucus said in a January 2022 budget analysis.\u003c/p>\n\u003cp>For his part, Newsom has played a critical role in propelling the movement forward, said Rachel Linn Gish, communications director for Health Access California. Newsom, who took office in 2019, campaigned on the \u003ca href=\"https://www.politico.com/states/california/story/2018/11/29/how-newsoms-big-win-gives-him-a-mandate-on-health-care-715530\" target=\"_blank\" rel=\"noreferrer noopener\">promise of establishing universal health care in California\u003c/a>, and advocates have spent the duration of his governorship pushing him to keep that promise.\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"‘You cannot talk about coverage for all if you’re not talking about coverage for everyone regardless of their immigration status.’","name":"pullquote","attributes":{"named":{"align":"right","size":"medium","citation":"Rachel Linn Gish, Health Access California","label":""},"numeric":[]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>“You cannot talk about coverage for all if you’re not talking about coverage for everyone regardless of their immigration status,” Linn Gish said. “Gov. Newsom made it a major platform of his from day one, and I think it’s hard to untie those two things.”\u003c/p>\n\u003cp>Newsom has faced pressure to do more for undocumented immigrants and to do it faster. Advocates and some legislators lobbied Newsom to roll out this last expansion sooner, in part because of the \u003ca href=\"https://calmatters.org/california-divide/2022/01/omicron-essential-workers-alone/\" target=\"_blank\" rel=\"noreferrer noopener\">disproportionate toll COVID-19 took on essential workers\u003c/a>, many of whom are undocumented.\u003c/p>\n\u003cp>This expansion is \u003ca href=\"https://ebudget.ca.gov/2022-23/pdf/Enacted/BudgetSummary/HealthandHumanServices.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">projected to cost\u003c/a> more than $835 million in the next six months and $2.6 billion every year after that. Previous expansions, which opened the door to more than 1.1 million undocumented enrollees, cost the state approximately $1.6 billion annually, according to \u003ca href=\"https://lao.ca.gov/Publications/Report/4423\" target=\"_blank\" rel=\"noreferrer noopener\">past Legislative Analyst’s Office reports\u003c/a>. The total $4 billion price tag, though significant, represents a fraction of Medi-Cal’s expansive $37 billion budget.\u003c/p>\n\u003cp>Still, many \u003ca href=\"https://calmatters.org/health/2022/02/medi-cal-expansion-immigrants/\" target=\"_blank\" rel=\"noreferrer noopener\">undocumented Californians will remain ineligible\u003c/a>\u003ca href=\"https://calmatters.org/health/2022/02/medi-cal-expansion-immigrants/\"> for health insurance\u003c/a>. Roughly half a million immigrants make too much money to qualify for Medi-Cal but still can’t afford private insurance. Advocates want to expand Covered California to include that population, but the state’s ballooning deficit makes that unlikely in the near future.\u003c/p>\n\u003ch2>Health disparities among undocumented immigrants\u003c/h2>\n\u003cp>Many undocumented immigrants avoid medical care, making it difficult to compare their health to other California residents. Some studies indicate they experience \u003ca href=\"https://www.ppic.org/publication/health-conditions-and-health-care-among-californias-undocumented-immigrants/\">higher rates of chronic conditions\u003c/a> like heart disease, asthma and high blood pressure. Immigrants without legal status in California are also \u003ca href=\"https://link.springer.com/article/10.1007/s11113-021-09689-w\">more likely to suffer from \u003c/a>\u003ca href=\"https://link.springer.com/article/10.1007/s11113-021-09689-w\" target=\"_blank\" rel=\"noreferrer noopener\">mental\u003c/a>\u003ca href=\"https://link.springer.com/article/10.1007/s11113-021-09689-w\"> distress and self-report poor health\u003c/a>.\u003c/p>\n\u003cp>Dr. Efrain Talamantes, chief operating officer at AltaMed in Los Angeles, the largest federally qualified health center in California, said he frequently sees young, undocumented individuals who feel healthy but “already are having the end damage of chronic conditions that have not been detected.”\u003c/p>\n\u003cp>The new Medi-Cal expansion will allow Talamantes and others who serve undocumented communities to give patients affordable, high-level care. Although California offers many undocumented immigrants emergency Medi-Cal, and \u003ca href=\"https://dhs.lacounty.gov/my-health-la/\">some counties fund their own programs\u003c/a>, services can be disjointed with monthslong wait times.\u003c/p>\n\u003cp>“When these patients now receive Medi-Cal and are part of a managed care health care plan with us, then we’re responsible for their entire care from primary and specialty to hospital care,” Talamantes said.\u003c/p>\n\u003cp>Miriam Pozuelos is one such potential beneficiary. The Los Angeles-area mother said the expansion lifts a huge financial burden from her family. She and her husband now pay out-of-pocket for any medical services and often go without. Both have already applied to full-scope Medi-Cal for January.\u003c/p>\n\u003cp>“When me and my family heard about this expansion, we were just really hoping that it would actually come true and that we can start getting the care that we need and not be worried about ‘I have to pay this enormous bill,’” Pozuelos said in Spanish.\u003c/p>\n\u003cp>Back at the St. John’s Community Health benefits center, Lopez helps another undocumented immigrant renew his emergency Medi-Cal, which will automatically roll over to full-scope next month. Wilder, 41, who requested his last name be withheld to protect him from immigration authorities, said he needs two root canals totaling $8,000. He has searched for months for a cheaper option without success, he said. He also needs medication for high blood pressure but can’t always afford it.\u003c/p>\n\u003cp>The Medi-Cal expansion means he’ll finally be able to take care of his health, Wilder said.\u003c/p>\n\u003cp>“It’s nice seeing them leaving happy and smiling,” Lopez said. “Even if it takes us three hours, they leave with a sense of relief that they can see the doctor.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>Supported by the California Health Care Foundation (CHCF), which works to ensure that\u003c/em> \u003cem>people have access to the care they need, when they need it, at a price they can afford. Visit \u003c/em>\u003ca href=\"http://www.chcf.org/\">\u003cem>www.chcf.org\u003c/em>\u003c/a>\u003cem> to learn more.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/news/11971102/california-becomes-first-state-to-offer-health-insurance-to-all-eligible-undocumented-adults","authors":["byline_news_11971102"],"categories":["news_8"],"tags":["news_27626","news_18543","news_683","news_2605","news_32785"],"affiliates":["news_18481"],"featImg":"news_11971104","label":"news_18481"},"news_11970414":{"type":"posts","id":"news_11970414","meta":{"index":"posts_1591205157","site":"news","id":"11970414","score":null,"sort":[1703016018000]},"guestAuthors":[],"slug":"they-told-me-i-have-no-coverage-californians-surprised-by-loss-of-medi-cal-insurance","title":"Over 930,000 Californians Lost Medi-Cal Coverage This Year Due to ‘Procedural Reasons’","publishDate":1703016018,"format":"standard","headTitle":"Over 930,000 Californians Lost Medi-Cal Coverage This Year Due to ‘Procedural Reasons’ | KQED","labelTerm":{"term":18481,"site":"news"},"content":"\u003cp>\u003cem>Lea este artículo en \u003ca href=\"https://calmatters.org/calmatters-en-espanol/2023/12/me-dijeron-que-no-tengo-cobertura-californianos-sorprendidos-por-haber-perdido-su-seguro-de-medi-cal/\">español\u003c/a>.\u003c/em>\u003c/p>\n\u003cp>Florinda Miguel took her 6-year-old daughter for a routine dentist appointment in early December, only to find out that her Medi-Cal coverage had lapsed.\u003c/p>\n\u003cp>It took her by surprise. She hadn’t needed to renew her kids’ Medi-Cal coverage in almost four years. The Los Angeles resident said she doesn’t recall getting any notices or renewal paperwork in the mail this year.\u003c/p>\n\u003cp>“I don’t know if they sent it, if it was lost. I don’t know, but I didn’t get it,” Miguel said.\u003c/p>\n\u003cp>Without coverage, her daughter’s dental exam would cost $60, plus the cost of any additional work that needed to be done, so Miguel postponed it until she could get her Medi-Cal reinstated.\u003c/p>\n\u003cp>This spring, \u003ca href=\"https://calmatters.org/health/2023/07/medi-cal-eligibility-california-review/\">states restarted their annual eligibility reviews\u003c/a> for lower-income people enrolled in Medicaid — better known as Medi-Cal in California — after the federal government paused them in 2020 so recipients could automatically maintain their health benefits during the COVID-19 pandemic.[pullquote align=\"right\" size=\"medium\" citation=\"Celia Valdez, Maternal and Child Health Access\"]‘During COVID, the message was ignore, ignore, don’t worry. For close to four years, we told people not to worry, and then all of a sudden, they had to worry.’[/pullquote]Now, six months into the renewed eligibility process, thousands of eligible Californians are finding out, often during doctor’s visits, that they’ve lost their coverage due to missing or incomplete paperwork.\u003c/p>\n\u003cp>More than 930,000 people have had their Medi-Cal coverage terminated this year, according to state data. The vast majority of them — close to 90% — lost coverage because of so-called “procedural reasons,” often entailing problems with paperwork. \u003ca href=\"https://www.kff.org/report-section/medicaid-enrollment-and-unwinding-tracker-overview/\">California has the country’s fourth highest rate\u003c/a> of terminations linked to procedural issues, according to the health policy research organization KFF (formerly known as the Kaiser Family Foundation).\u003c/p>\n\u003cp>Among Californians eligible for Medi-Cal renewals, 47% retained coverage, 15% were kicked off for paperwork problems, 2% no longer qualified and 35% are still under review, the KFF tracker shows.\u003c/p>\n\u003cp>People who lose their \u003ca href=\"https://www.dhcs.ca.gov/keep-your-Medi-Cal/Pages/I-got-a-renewal-form.aspx\">Medi-Cal coverage but are still eligible\u003c/a> can hop back on within a 90-day grace period as long as they submit any missing information through the mail or online. As of October, the program covered 15.1 million people in California.\u003c/p>\n\u003cp>“During COVID, the message was ignore, ignore, don’t worry. For close to four years, we told people not to worry, and then all of a sudden, they had to worry,” said Celia Valdez, director of outreach and education at the Los Angeles nonprofit Maternal and Child Health Access. Her organization helped Miguel reinstate her kids’ Medi-Cal. But experiences like Miguel’s are common, she said.\u003c/p>\n\u003cp>“Many [enrollees] are saying, ‘I couldn’t fill my prescription, I went to the doctor and they told me I have no coverage,’” Valdez said.\u003c/p>\n\u003cp>People who are being disenrolled for “procedural reasons” tend to fall into several buckets, including those who are new to the program and may not understand that they now have to respond to yearly reviews, said Yingjia Huang, assistant deputy director at the California Department of Health Care Services, the state agency that oversees the Medi-Cal program.\u003c/p>\n\u003cp>Other people may now have health insurance through an employer and are not filling out their paperwork because they no longer need Medi-Cal nor would they qualify, Huang said. And some who moved during the pandemic may not have received the renewal alert this year because they neglected to report their new address to their county Medi-Cal office.[aside label=\"more on medi-cal\" tag=\"medi-cal\"]And in some cases, advocates add, county offices may not be processing paperwork on time that was submitted close to the deadline.\u003c/p>\n\u003cp>The Children’s Partnership, a nonprofit children’s advocacy organization, last week \u003ca href=\"https://childrenspartnership.org/wp-content/uploads/2023/03/101691-000_Packard_FinishLine_CA_Deck.pptx.pdf\">published a report \u003c/a>about parents’ and guardians’ experiences with renewing their families’ Medi-Cal. The report noted several obstacles that parents said contributed to their children losing coverage, including unreturned phone calls, long call wait times, confusing instructions, limited access to translators, feelings of discrimination, and lack of awareness.\u003c/p>\n\u003cp>According to the report, gaps in coverage led to delays in care, missed medications and out-of-pocket costs for families.\u003c/p>\n\u003cp>Huang, with the Department of Health Care Services, said the state is working to increase the number of people whose coverage can be renewed automatically using state electronic databases that can verify an enrollee’s income and eligibility.\u003c/p>\n\u003cp>“Our [automatic renewal] rates historically have been lower than many of the other states — they probably have more electronic sources and databases that they can use,” Huang said. She noted the state has been receiving automation tips and technical assistance from the federal government to increase the number of cases that can be renewed automatically.\u003c/p>\n\u003cp>“That just eases the administrative burden on our members as well as our counties,” Huang said.\u003c/p>\n\u003cp>Valdez and other health advocates said there are significant gaps in support for people who have questions or need assistance. She said that calling county Medi-Cal offices can result in hours-long waits, and organizations like hers have limited capacity to fill in the gaps. People who are not connected to an advocate or an enrollment counselor could get lost in the process.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Among the \u003ca href=\"https://calmatters.org/health/2023/09/what-to-do-if-you-lose-medi-cal-health-insurance/\">top questions and comments\u003c/a> from people seeking assistance is that the paperwork is too much or too confusing, said Kimberley Graham, director of patient access at AltaMed Health Services, a clinic system in Los Angeles and Orange counties that provides enrollment services.\u003c/p>\n\u003cp>“And they don’t know what to do. So often, the packets are opened, but they’re completely blank,” Graham said. “The next question is, ‘Do I have to do this every year?’”\u003c/p>\n\u003cp>The answer, she said, is “yes.”\u003c/p>\n\u003cp>\u003cem>Supported by the California Health Care Foundation (CHCF), which works to ensure that\u003c/em> \u003cem>people have access to the care they need, when they need it, at a price they can afford. Visit \u003c/em>\u003ca href=\"http://www.chcf.org/\">\u003cem>www.chcf.org\u003c/em>\u003c/a>\u003cem> to learn more.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\n","blocks":[],"excerpt":"An annual renewal requirement for Medi-Cal was recently reinstated after being suspended for years during the pandemic, causing scores of Californians to unknowingly lose their coverage. ","status":"publish","parent":0,"modified":1703016546,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":25,"wordCount":1084},"headData":{"title":"Over 930,000 Californians Lost Medi-Cal Coverage This Year Due to ‘Procedural Reasons’ | KQED","description":"An annual renewal requirement for Medi-Cal was recently reinstated after being suspended for years during the pandemic, causing scores of Californians to unknowingly lose their coverage. ","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":""},"sticky":false,"nprByline":"\u003ca href=\"https://calmatters.org/author/anaibarra/\">Ana Ibarra\u003c/a>","excludeFromSiteSearch":"Include","showOnAuthorArchivePages":"No","articleAge":"0","path":"/news/11970414/they-told-me-i-have-no-coverage-californians-surprised-by-loss-of-medi-cal-insurance","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cem>Lea este artículo en \u003ca href=\"https://calmatters.org/calmatters-en-espanol/2023/12/me-dijeron-que-no-tengo-cobertura-californianos-sorprendidos-por-haber-perdido-su-seguro-de-medi-cal/\">español\u003c/a>.\u003c/em>\u003c/p>\n\u003cp>Florinda Miguel took her 6-year-old daughter for a routine dentist appointment in early December, only to find out that her Medi-Cal coverage had lapsed.\u003c/p>\n\u003cp>It took her by surprise. She hadn’t needed to renew her kids’ Medi-Cal coverage in almost four years. The Los Angeles resident said she doesn’t recall getting any notices or renewal paperwork in the mail this year.\u003c/p>\n\u003cp>“I don’t know if they sent it, if it was lost. I don’t know, but I didn’t get it,” Miguel said.\u003c/p>\n\u003cp>Without coverage, her daughter’s dental exam would cost $60, plus the cost of any additional work that needed to be done, so Miguel postponed it until she could get her Medi-Cal reinstated.\u003c/p>\n\u003cp>This spring, \u003ca href=\"https://calmatters.org/health/2023/07/medi-cal-eligibility-california-review/\">states restarted their annual eligibility reviews\u003c/a> for lower-income people enrolled in Medicaid — better known as Medi-Cal in California — after the federal government paused them in 2020 so recipients could automatically maintain their health benefits during the COVID-19 pandemic.\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"‘During COVID, the message was ignore, ignore, don’t worry. For close to four years, we told people not to worry, and then all of a sudden, they had to worry.’","name":"pullquote","attributes":{"named":{"align":"right","size":"medium","citation":"Celia Valdez, Maternal and Child Health Access","label":""},"numeric":[]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>Now, six months into the renewed eligibility process, thousands of eligible Californians are finding out, often during doctor’s visits, that they’ve lost their coverage due to missing or incomplete paperwork.\u003c/p>\n\u003cp>More than 930,000 people have had their Medi-Cal coverage terminated this year, according to state data. The vast majority of them — close to 90% — lost coverage because of so-called “procedural reasons,” often entailing problems with paperwork. \u003ca href=\"https://www.kff.org/report-section/medicaid-enrollment-and-unwinding-tracker-overview/\">California has the country’s fourth highest rate\u003c/a> of terminations linked to procedural issues, according to the health policy research organization KFF (formerly known as the Kaiser Family Foundation).\u003c/p>\n\u003cp>Among Californians eligible for Medi-Cal renewals, 47% retained coverage, 15% were kicked off for paperwork problems, 2% no longer qualified and 35% are still under review, the KFF tracker shows.\u003c/p>\n\u003cp>People who lose their \u003ca href=\"https://www.dhcs.ca.gov/keep-your-Medi-Cal/Pages/I-got-a-renewal-form.aspx\">Medi-Cal coverage but are still eligible\u003c/a> can hop back on within a 90-day grace period as long as they submit any missing information through the mail or online. As of October, the program covered 15.1 million people in California.\u003c/p>\n\u003cp>“During COVID, the message was ignore, ignore, don’t worry. For close to four years, we told people not to worry, and then all of a sudden, they had to worry,” said Celia Valdez, director of outreach and education at the Los Angeles nonprofit Maternal and Child Health Access. Her organization helped Miguel reinstate her kids’ Medi-Cal. But experiences like Miguel’s are common, she said.\u003c/p>\n\u003cp>“Many [enrollees] are saying, ‘I couldn’t fill my prescription, I went to the doctor and they told me I have no coverage,’” Valdez said.\u003c/p>\n\u003cp>People who are being disenrolled for “procedural reasons” tend to fall into several buckets, including those who are new to the program and may not understand that they now have to respond to yearly reviews, said Yingjia Huang, assistant deputy director at the California Department of Health Care Services, the state agency that oversees the Medi-Cal program.\u003c/p>\n\u003cp>Other people may now have health insurance through an employer and are not filling out their paperwork because they no longer need Medi-Cal nor would they qualify, Huang said. And some who moved during the pandemic may not have received the renewal alert this year because they neglected to report their new address to their county Medi-Cal office.\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"aside","attributes":{"named":{"label":"more on medi-cal ","tag":"medi-cal"},"numeric":[]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>And in some cases, advocates add, county offices may not be processing paperwork on time that was submitted close to the deadline.\u003c/p>\n\u003cp>The Children’s Partnership, a nonprofit children’s advocacy organization, last week \u003ca href=\"https://childrenspartnership.org/wp-content/uploads/2023/03/101691-000_Packard_FinishLine_CA_Deck.pptx.pdf\">published a report \u003c/a>about parents’ and guardians’ experiences with renewing their families’ Medi-Cal. The report noted several obstacles that parents said contributed to their children losing coverage, including unreturned phone calls, long call wait times, confusing instructions, limited access to translators, feelings of discrimination, and lack of awareness.\u003c/p>\n\u003cp>According to the report, gaps in coverage led to delays in care, missed medications and out-of-pocket costs for families.\u003c/p>\n\u003cp>Huang, with the Department of Health Care Services, said the state is working to increase the number of people whose coverage can be renewed automatically using state electronic databases that can verify an enrollee’s income and eligibility.\u003c/p>\n\u003cp>“Our [automatic renewal] rates historically have been lower than many of the other states — they probably have more electronic sources and databases that they can use,” Huang said. She noted the state has been receiving automation tips and technical assistance from the federal government to increase the number of cases that can be renewed automatically.\u003c/p>\n\u003cp>“That just eases the administrative burden on our members as well as our counties,” Huang said.\u003c/p>\n\u003cp>Valdez and other health advocates said there are significant gaps in support for people who have questions or need assistance. She said that calling county Medi-Cal offices can result in hours-long waits, and organizations like hers have limited capacity to fill in the gaps. People who are not connected to an advocate or an enrollment counselor could get lost in the process.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Among the \u003ca href=\"https://calmatters.org/health/2023/09/what-to-do-if-you-lose-medi-cal-health-insurance/\">top questions and comments\u003c/a> from people seeking assistance is that the paperwork is too much or too confusing, said Kimberley Graham, director of patient access at AltaMed Health Services, a clinic system in Los Angeles and Orange counties that provides enrollment services.\u003c/p>\n\u003cp>“And they don’t know what to do. So often, the packets are opened, but they’re completely blank,” Graham said. “The next question is, ‘Do I have to do this every year?’”\u003c/p>\n\u003cp>The answer, she said, is “yes.”\u003c/p>\n\u003cp>\u003cem>Supported by the California Health Care Foundation (CHCF), which works to ensure that\u003c/em> \u003cem>people have access to the care they need, when they need it, at a price they can afford. Visit \u003c/em>\u003ca href=\"http://www.chcf.org/\">\u003cem>www.chcf.org\u003c/em>\u003c/a>\u003cem> to learn more.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/news/11970414/they-told-me-i-have-no-coverage-californians-surprised-by-loss-of-medi-cal-insurance","authors":["byline_news_11970414"],"categories":["news_457"],"tags":["news_27626","news_18543","news_683","news_33675","news_2605","news_30761","news_20666"],"affiliates":["news_18481"],"featImg":"news_11970417","label":"news_18481"},"news_11964609":{"type":"posts","id":"news_11964609","meta":{"index":"posts_1591205157","site":"news","id":"11964609","score":null,"sort":[1697414425000]},"guestAuthors":[],"slug":"families-fume-over-newsoms-veto-of-childrens-hearing-aid-bill","title":"Families Fume Over Newsom’s Veto of Children’s Hearing Aid Bill","publishDate":1697414425,"format":"standard","headTitle":"Families Fume Over Newsom’s Veto of Children’s Hearing Aid Bill | KQED","labelTerm":{"term":18481,"site":"news"},"content":"\u003cp>Two of Johanna Wonderly’s four children depend on hearing aids, and the other two will probably need them in the future. At roughly $6,000 per child, the cost adds up quickly.\u003c/p>\n\u003cp>But the Roseville family can only afford them when Wonderly’s husband, Paul, is called to active duty for the California Army National Guard, because that’s when federal coverage kicks in. The family’s standard insurance does not cover hearing aids.\u003c/p>\n\u003cp>Her second oldest daughter, Cara, was born while Paul was working at his then-private-sector job as a bartender. His insurance denied their claim for a hearing aid. A state-run program for children with disabilities or chronic medical conditions said the family made too much money to qualify for help. The Wonderlys applied for assistance through a national non-profit and crossed their fingers.\u003c/p>\n\u003cp>[pullquote size=\"medium\" align=\"right\" citation=\"Dr. Dylan Chan, director, Children’s Communication Center at UC San Francisco\"]‘It would be like being able to diagnose a child with asthma but not giving them an inhaler.’[/pullquote]“We were living paycheck-to-paycheck back then. We didn’t have savings if my husband lost his job, let alone pay for an unexpected $6,000 expense,” Johanna Wonderly said. “We were going to have to say ‘Sorry, Cara. You don’t get hearing aids.’”\u003c/p>\n\u003cp>The Legislature this year unanimously passed a measure that would have helped families like hers by \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=202320240SB635\">requiring health insurers to cover hearing aids\u003c/a> for anyone under 21. Most private health insurance in California designates children’s hearing aids as cosmetic or elective devices.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>But over the weekend \u003ca href=\"https://www.gov.ca.gov/wp-content/uploads/2023/10/SB-635-Veto.pdf\">Gov. Gavin Newsom vetoed the bill\u003c/a>, citing improvements made to an existing state program established in 2021 to help families afford hearing aids. It’s the second time Newsom has effectively blocked this legislation and pointed to the state’s Hearing Aid Coverage for Children Program as an alternative. Advocates and some legislators say that program has failed.\u003c/p>\n\u003cp>[aside postID=\"news_11963514,news_11964331,news_11963061\" label=\"Related Stories\"]In his veto message, Newsom cites concern about creating a costly precedent by adding benefits to the state’s Affordable Care Act insurance exchange, known as Covered California. A legislative analysis estimates the added cost at about $11 million.\u003c/p>\n\u003cp>Newsom also said improving access to children’s hearing aids remained a priority for his administration.\u003c/p>\n\u003cp>“We can, and we must, do better for these children and their families as we implement” the Hearing Aid Coverage for Children Program, the message said.\u003c/p>\n\u003cp>Children’s advocates say the program will never work.\u003c/p>\n\u003cp>“There’s been two years of oversight hearings on this program. It’s not working, so to double down on a failing program it’s not only harmful to children, it’s wasting, you know, millions of taxpayers dollars,” said Michelle Marciniak, co-founder of \u003ca href=\"https://letcakidshear.com/\">Let California Kids Hear\u003c/a>, a parent advocacy group that sponsored the legislation. Marciniak’s daughter lost partial hearing after a viral infection.\u003c/p>\n\u003ch2>Lifelong impact of hearing loss\u003c/h2>\n\u003cp>Research shows infants and children who cannot hear can develop permanent speech, language, and cognitive deficits. They quickly fall behind in school, suffering delayed reading comprehension and social and emotional problems. Those who get an assistive device like a \u003ca href=\"https://publications.aap.org/pediatrics/article/146/4/e20200557/79717/Kindergarten-Readiness-in-Children-Who-Are-Deaf-or?autologincheck=redirected\">hearing aid within the first six months\u003c/a> of life have much better outcomes.\u003c/p>\n\u003cp>“If you have a child that’s born with hearing loss and doesn’t get hearing aids until the age of 3 or 4, this kid is going to be delayed for the rest of their life,” said Dr. Daniela Carvalho, director of Rady Children’s Hospital-San Diego’s hearing program, who testified in support of the measure.\u003c/p>\n\u003cfigure id=\"attachment_11964611\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/10/2023/10/101223-Hearing-Aid-Veto-JYO-CM-15-scaled-1.jpg\">\u003cimg decoding=\"async\" loading=\"lazy\" class=\"size-medium wp-image-11964611\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/10/101223-Hearing-Aid-Veto-JYO-CM-15-scaled-1-800x533.jpg\" alt=\"A young white girl with a hearing aid and red shirt leans over a desk holding a pencil to a piece of paper.\" width=\"800\" height=\"533\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2023/10/101223-Hearing-Aid-Veto-JYO-CM-15-scaled-1-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/10/2023/10/101223-Hearing-Aid-Veto-JYO-CM-15-scaled-1-1020x680.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/10/2023/10/101223-Hearing-Aid-Veto-JYO-CM-15-scaled-1-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/10/2023/10/101223-Hearing-Aid-Veto-JYO-CM-15-scaled-1-1536x1024.jpg 1536w, https://ww2.kqed.org/app/uploads/sites/10/2023/10/101223-Hearing-Aid-Veto-JYO-CM-15-scaled-1-2048x1366.jpg 2048w, https://ww2.kqed.org/app/uploads/sites/10/2023/10/101223-Hearing-Aid-Veto-JYO-CM-15-scaled-1-1920x1280.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Cassie, 9, works on her homework on Oct. 11, 2023. \u003ccite>(Jyotsana Bhamidipati/CalMatters)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Dr. Dylan Chan, director of the Children’s Communication Center at UC San Francisco, said the impact on a child’s life is so profound that hospitals are required by state and federal law to test every newborn for hearing problems.\u003c/p>\n\u003cp>“But identifying kids with hearing loss does no good if we don’t have the ability to provide the appropriate interventions,” Chan said. “It would be like being able to diagnose a child with asthma but not giving them an inhaler.”\u003c/p>\n\u003cp>Carvalho said several of her patients’ families were waiting for the legislation to pass to be able to afford hearing aids.\u003c/p>\n\u003cp>“They have their hands tied. I mean it literally is a choice that the family needs to make. It’s a huge financial decision,” Carvalho said.\u003c/p>\n\u003ch2>Support for hearing aid bill\u003c/h2>\n\u003cp>Marciniak, the advocate who has helped lead the fight for coverage since 2019, said lawmakers brought the bill back this year because the Hearing Aid Coverage for Children Program has been ineffective since it launched in 2021.\u003c/p>\n\u003cp>“This is definitely a broken promise,” Marciniak said. “And it’s disappointing because they haven’t been willing to come to the table to solve this with us in a meaningful way.”\u003c/p>\n\u003cp>Most states already include hearing aid coverage in their insurance exchanges. Thirty-two states require private insurance to offer some level of coverage for kids’ hearing aids, including 27 that mandate it as a benefit under the Affordable Care Act. California only offers coverage to very low-income families through public insurance like Medi-Cal or the program for kids with disabilities, setting the income cap for a family of four around $40,000.\u003c/p>\n\u003cp>The state’s coverage gap leaves 20,000 kids and young adults whose families don’t qualify for low-income assistance, according to a \u003ca href=\"https://www.chbrp.org/sites/default/files/bill-documents/SB0/Abbreviated%20Analysis%20of%20SB%20635%20Hearing%20Aids%20FINAL%20060923.pdf\">California Health Benefits Review Program analysis for the Legislature\u003c/a>. That represents nearly half of all hearing aid users between the ages of 0 and 20.\u003c/p>\n\u003cp>In 2019 a similar bill passed unanimously and was sent to Newsom. At the time, former Santa Monica Democratic Assemblymember Richard Bloom, the bill author, told \u003ca href=\"https://calmatters.org/health/2022/08/childrens-hearing-aids/\">CalMatters\u003c/a> that Newsom asked him to rescind the bill with a promise to create a budget fix.\u003c/p>\n\u003cp>That “fix” came in the form of the Hearing Aid Coverage for Children Program. The program, which received $16 million its first year, \u003ca href=\"https://calmatters.org/health/2022/08/childrens-hearing-aids/\">distributed hearing aids to 39 children\u003c/a> and has been harshly criticized by legislators demanding accountability. Last year another budget allocation \u003ca href=\"https://calmatters.org/health/2022/09/children-hearing-aids/\">expanded eligibility to about 7,000 kids\u003c/a> and doubled the budget. Currently, \u003ca href=\"https://www.dhcs.ca.gov/services/HACCP/Pages/Partners/Program-Data.aspx\">255 children\u003c/a> — roughly half of all applicants — have gotten hearing aids, according to state data.\u003c/p>\n\u003cp>Parents say they can’t find providers who participate, the application process is lengthy and confusing, and resources are unavailable for people who don’t speak English.\u003c/p>\n\u003cfigure id=\"attachment_11964612\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/10/2023/10/101223-Hearing-Aid-Veto-JYO-CM-19.jpg\">\u003cimg decoding=\"async\" loading=\"lazy\" class=\"size-medium wp-image-11964612\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/10/101223-Hearing-Aid-Veto-JYO-CM-19-800x533.jpg\" alt=\"Three young white girls sit against a wall with an illustration while the middle child holds a baby.\" width=\"800\" height=\"533\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2023/10/101223-Hearing-Aid-Veto-JYO-CM-19-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/10/2023/10/101223-Hearing-Aid-Veto-JYO-CM-19-1020x680.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/10/2023/10/101223-Hearing-Aid-Veto-JYO-CM-19-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/10/2023/10/101223-Hearing-Aid-Veto-JYO-CM-19-1536x1024.jpg 1536w, https://ww2.kqed.org/app/uploads/sites/10/2023/10/101223-Hearing-Aid-Veto-JYO-CM-19-1920x1280.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/10/2023/10/101223-Hearing-Aid-Veto-JYO-CM-19.jpg 2000w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">From left Caitlyn, Cassie, Carter and Cara in Roseville on Oct. 11, 2023. \u003ccite>(Jyotsana Bhamidipati/CalMatters)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Kasey Cain, a mom from Lincoln and board president of California Hands and Voices, said she spent nine months fighting red tape. She sent required paperwork to the program in a pre-addressed envelope from the state. It was returned as undeliverable.\u003c/p>\n\u003cp>“It was a nightmare. I started to receive calls that they were going to close my account because they never received the documents,” Cain said. “I don’t know why your self-addressed envelope doesn’t work.”\u003c/p>\n\u003cp>Eventually, she and her husband gave up and put the $2,500 charge on a credit card. They couldn’t wait any longer to update their 7-year-old son’s hearing aid. Later, when one of his hearing aids was replaced by a cochlear implant, insurance considered it a necessary medical device and covered it. The family was responsible for a $15 copay.\u003c/p>\n\u003cp>Newsom’s veto message said the Department of Health Care Services, which manages the hearing aid program, has developed an improvement plan that will be implemented over the next six months.\u003c/p>\n\u003cp>A representative from the Department of Health Care Services in a written statement said the department has moved its application process online and translated materials into 19 languages. Information about the program is also mailed to all parents’ whose children are identified with hearing loss at birth.\u003c/p>\n\u003ch2>California Democrats want to try again\u003c/h2>\n\u003cp>Sen. Caroline Menjivar, a Democrat from Burbank, co-authored this year’s measure with Democratic Sen. Anthony Portantino from Glendale.\u003c/p>\n\u003cp>“I’m not sure why we haven’t been able to pass it,” Menjivar said during the bill’s final floor vote. “We are behind close to 30 states that have already implemented this. Let’s be the next one.”\u003c/p>\n\u003cp>In a statement following the veto, Menjivar pledged to hold the administration accountable.\u003c/p>\n\u003cp>Wonderly, the mom of four, said it took 14 months for her eldest daughter Cassie’s hearing loss to get diagnosed. She worried that Cassie, who didn’t respond to sound and who had the limited eyesight normal for newborns, wouldn’t know who her parents were.\u003c/p>\n\u003cp>“Every night I fell asleep with my hand on my baby because I wanted her to know that she was secure, she was safe. That she knew that we were there for her,” Wonderly said.\u003c/p>\n\u003cp>Wonderly said eventually the national grant program paid for her second daughter’s hearing aids. But soon Cassie, now 9, will need an updated pair, and Wonderly’s two other children, ages 7 and 1, who also have hearing loss, will likely need hearing aids in the future.\u003c/p>\n\u003cp>The closest provider that participates in the Hearing Aid Coverage for Children Program is more than 100 miles away, Wonderly said.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>Supported by the California Health Care Foundation (CHCF), which works to ensure that people have access to the care they need, when they need it, at a price they can afford. Visit \u003ca href=\"http://www.chcf.org/\">www.chcf.org\u003c/a> to learn more.\u003c/em>\u003c/p>\n\n","blocks":[],"excerpt":"More than 30 states require insurers to provide some level of coverage for kids’ hearing aids. California isn’t one of them, and Gov. Newsom for the second time has vetoed a bill to close that gap.","status":"publish","parent":0,"modified":1697413476,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":39,"wordCount":1685},"headData":{"title":"Families Fume Over Newsom’s Veto of Children’s Hearing Aid Bill | KQED","description":"More than 30 states require insurers to provide some level of coverage for kids’ hearing aids. California isn’t one of them, and Gov. Newsom for the second time has vetoed a bill to close that gap.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":""},"nprByline":"Kristen Hwang","excludeFromSiteSearch":"Include","showOnAuthorArchivePages":"No","articleAge":"0","path":"/news/11964609/families-fume-over-newsoms-veto-of-childrens-hearing-aid-bill","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Two of Johanna Wonderly’s four children depend on hearing aids, and the other two will probably need them in the future. At roughly $6,000 per child, the cost adds up quickly.\u003c/p>\n\u003cp>But the Roseville family can only afford them when Wonderly’s husband, Paul, is called to active duty for the California Army National Guard, because that’s when federal coverage kicks in. The family’s standard insurance does not cover hearing aids.\u003c/p>\n\u003cp>Her second oldest daughter, Cara, was born while Paul was working at his then-private-sector job as a bartender. His insurance denied their claim for a hearing aid. A state-run program for children with disabilities or chronic medical conditions said the family made too much money to qualify for help. The Wonderlys applied for assistance through a national non-profit and crossed their fingers.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"‘It would be like being able to diagnose a child with asthma but not giving them an inhaler.’","name":"pullquote","attributes":{"named":{"size":"medium","align":"right","citation":"Dr. Dylan Chan, director, Children’s Communication Center at UC San Francisco","label":""},"numeric":[]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>“We were living paycheck-to-paycheck back then. We didn’t have savings if my husband lost his job, let alone pay for an unexpected $6,000 expense,” Johanna Wonderly said. “We were going to have to say ‘Sorry, Cara. You don’t get hearing aids.’”\u003c/p>\n\u003cp>The Legislature this year unanimously passed a measure that would have helped families like hers by \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=202320240SB635\">requiring health insurers to cover hearing aids\u003c/a> for anyone under 21. Most private health insurance in California designates children’s hearing aids as cosmetic or elective devices.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>But over the weekend \u003ca href=\"https://www.gov.ca.gov/wp-content/uploads/2023/10/SB-635-Veto.pdf\">Gov. Gavin Newsom vetoed the bill\u003c/a>, citing improvements made to an existing state program established in 2021 to help families afford hearing aids. It’s the second time Newsom has effectively blocked this legislation and pointed to the state’s Hearing Aid Coverage for Children Program as an alternative. Advocates and some legislators say that program has failed.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"aside","attributes":{"named":{"postid":"news_11963514,news_11964331,news_11963061","label":"Related Stories "},"numeric":[]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>In his veto message, Newsom cites concern about creating a costly precedent by adding benefits to the state’s Affordable Care Act insurance exchange, known as Covered California. A legislative analysis estimates the added cost at about $11 million.\u003c/p>\n\u003cp>Newsom also said improving access to children’s hearing aids remained a priority for his administration.\u003c/p>\n\u003cp>“We can, and we must, do better for these children and their families as we implement” the Hearing Aid Coverage for Children Program, the message said.\u003c/p>\n\u003cp>Children’s advocates say the program will never work.\u003c/p>\n\u003cp>“There’s been two years of oversight hearings on this program. It’s not working, so to double down on a failing program it’s not only harmful to children, it’s wasting, you know, millions of taxpayers dollars,” said Michelle Marciniak, co-founder of \u003ca href=\"https://letcakidshear.com/\">Let California Kids Hear\u003c/a>, a parent advocacy group that sponsored the legislation. Marciniak’s daughter lost partial hearing after a viral infection.\u003c/p>\n\u003ch2>Lifelong impact of hearing loss\u003c/h2>\n\u003cp>Research shows infants and children who cannot hear can develop permanent speech, language, and cognitive deficits. They quickly fall behind in school, suffering delayed reading comprehension and social and emotional problems. Those who get an assistive device like a \u003ca href=\"https://publications.aap.org/pediatrics/article/146/4/e20200557/79717/Kindergarten-Readiness-in-Children-Who-Are-Deaf-or?autologincheck=redirected\">hearing aid within the first six months\u003c/a> of life have much better outcomes.\u003c/p>\n\u003cp>“If you have a child that’s born with hearing loss and doesn’t get hearing aids until the age of 3 or 4, this kid is going to be delayed for the rest of their life,” said Dr. Daniela Carvalho, director of Rady Children’s Hospital-San Diego’s hearing program, who testified in support of the measure.\u003c/p>\n\u003cfigure id=\"attachment_11964611\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/10/2023/10/101223-Hearing-Aid-Veto-JYO-CM-15-scaled-1.jpg\">\u003cimg decoding=\"async\" loading=\"lazy\" class=\"size-medium wp-image-11964611\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/10/101223-Hearing-Aid-Veto-JYO-CM-15-scaled-1-800x533.jpg\" alt=\"A young white girl with a hearing aid and red shirt leans over a desk holding a pencil to a piece of paper.\" width=\"800\" height=\"533\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2023/10/101223-Hearing-Aid-Veto-JYO-CM-15-scaled-1-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/10/2023/10/101223-Hearing-Aid-Veto-JYO-CM-15-scaled-1-1020x680.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/10/2023/10/101223-Hearing-Aid-Veto-JYO-CM-15-scaled-1-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/10/2023/10/101223-Hearing-Aid-Veto-JYO-CM-15-scaled-1-1536x1024.jpg 1536w, https://ww2.kqed.org/app/uploads/sites/10/2023/10/101223-Hearing-Aid-Veto-JYO-CM-15-scaled-1-2048x1366.jpg 2048w, https://ww2.kqed.org/app/uploads/sites/10/2023/10/101223-Hearing-Aid-Veto-JYO-CM-15-scaled-1-1920x1280.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Cassie, 9, works on her homework on Oct. 11, 2023. \u003ccite>(Jyotsana Bhamidipati/CalMatters)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Dr. Dylan Chan, director of the Children’s Communication Center at UC San Francisco, said the impact on a child’s life is so profound that hospitals are required by state and federal law to test every newborn for hearing problems.\u003c/p>\n\u003cp>“But identifying kids with hearing loss does no good if we don’t have the ability to provide the appropriate interventions,” Chan said. “It would be like being able to diagnose a child with asthma but not giving them an inhaler.”\u003c/p>\n\u003cp>Carvalho said several of her patients’ families were waiting for the legislation to pass to be able to afford hearing aids.\u003c/p>\n\u003cp>“They have their hands tied. I mean it literally is a choice that the family needs to make. It’s a huge financial decision,” Carvalho said.\u003c/p>\n\u003ch2>Support for hearing aid bill\u003c/h2>\n\u003cp>Marciniak, the advocate who has helped lead the fight for coverage since 2019, said lawmakers brought the bill back this year because the Hearing Aid Coverage for Children Program has been ineffective since it launched in 2021.\u003c/p>\n\u003cp>“This is definitely a broken promise,” Marciniak said. “And it’s disappointing because they haven’t been willing to come to the table to solve this with us in a meaningful way.”\u003c/p>\n\u003cp>Most states already include hearing aid coverage in their insurance exchanges. Thirty-two states require private insurance to offer some level of coverage for kids’ hearing aids, including 27 that mandate it as a benefit under the Affordable Care Act. California only offers coverage to very low-income families through public insurance like Medi-Cal or the program for kids with disabilities, setting the income cap for a family of four around $40,000.\u003c/p>\n\u003cp>The state’s coverage gap leaves 20,000 kids and young adults whose families don’t qualify for low-income assistance, according to a \u003ca href=\"https://www.chbrp.org/sites/default/files/bill-documents/SB0/Abbreviated%20Analysis%20of%20SB%20635%20Hearing%20Aids%20FINAL%20060923.pdf\">California Health Benefits Review Program analysis for the Legislature\u003c/a>. That represents nearly half of all hearing aid users between the ages of 0 and 20.\u003c/p>\n\u003cp>In 2019 a similar bill passed unanimously and was sent to Newsom. At the time, former Santa Monica Democratic Assemblymember Richard Bloom, the bill author, told \u003ca href=\"https://calmatters.org/health/2022/08/childrens-hearing-aids/\">CalMatters\u003c/a> that Newsom asked him to rescind the bill with a promise to create a budget fix.\u003c/p>\n\u003cp>That “fix” came in the form of the Hearing Aid Coverage for Children Program. The program, which received $16 million its first year, \u003ca href=\"https://calmatters.org/health/2022/08/childrens-hearing-aids/\">distributed hearing aids to 39 children\u003c/a> and has been harshly criticized by legislators demanding accountability. Last year another budget allocation \u003ca href=\"https://calmatters.org/health/2022/09/children-hearing-aids/\">expanded eligibility to about 7,000 kids\u003c/a> and doubled the budget. Currently, \u003ca href=\"https://www.dhcs.ca.gov/services/HACCP/Pages/Partners/Program-Data.aspx\">255 children\u003c/a> — roughly half of all applicants — have gotten hearing aids, according to state data.\u003c/p>\n\u003cp>Parents say they can’t find providers who participate, the application process is lengthy and confusing, and resources are unavailable for people who don’t speak English.\u003c/p>\n\u003cfigure id=\"attachment_11964612\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/10/2023/10/101223-Hearing-Aid-Veto-JYO-CM-19.jpg\">\u003cimg decoding=\"async\" loading=\"lazy\" class=\"size-medium wp-image-11964612\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/10/101223-Hearing-Aid-Veto-JYO-CM-19-800x533.jpg\" alt=\"Three young white girls sit against a wall with an illustration while the middle child holds a baby.\" width=\"800\" height=\"533\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2023/10/101223-Hearing-Aid-Veto-JYO-CM-19-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/10/2023/10/101223-Hearing-Aid-Veto-JYO-CM-19-1020x680.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/10/2023/10/101223-Hearing-Aid-Veto-JYO-CM-19-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/10/2023/10/101223-Hearing-Aid-Veto-JYO-CM-19-1536x1024.jpg 1536w, https://ww2.kqed.org/app/uploads/sites/10/2023/10/101223-Hearing-Aid-Veto-JYO-CM-19-1920x1280.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/10/2023/10/101223-Hearing-Aid-Veto-JYO-CM-19.jpg 2000w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">From left Caitlyn, Cassie, Carter and Cara in Roseville on Oct. 11, 2023. \u003ccite>(Jyotsana Bhamidipati/CalMatters)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Kasey Cain, a mom from Lincoln and board president of California Hands and Voices, said she spent nine months fighting red tape. She sent required paperwork to the program in a pre-addressed envelope from the state. It was returned as undeliverable.\u003c/p>\n\u003cp>“It was a nightmare. I started to receive calls that they were going to close my account because they never received the documents,” Cain said. “I don’t know why your self-addressed envelope doesn’t work.”\u003c/p>\n\u003cp>Eventually, she and her husband gave up and put the $2,500 charge on a credit card. They couldn’t wait any longer to update their 7-year-old son’s hearing aid. Later, when one of his hearing aids was replaced by a cochlear implant, insurance considered it a necessary medical device and covered it. The family was responsible for a $15 copay.\u003c/p>\n\u003cp>Newsom’s veto message said the Department of Health Care Services, which manages the hearing aid program, has developed an improvement plan that will be implemented over the next six months.\u003c/p>\n\u003cp>A representative from the Department of Health Care Services in a written statement said the department has moved its application process online and translated materials into 19 languages. Information about the program is also mailed to all parents’ whose children are identified with hearing loss at birth.\u003c/p>\n\u003ch2>California Democrats want to try again\u003c/h2>\n\u003cp>Sen. Caroline Menjivar, a Democrat from Burbank, co-authored this year’s measure with Democratic Sen. Anthony Portantino from Glendale.\u003c/p>\n\u003cp>“I’m not sure why we haven’t been able to pass it,” Menjivar said during the bill’s final floor vote. “We are behind close to 30 states that have already implemented this. Let’s be the next one.”\u003c/p>\n\u003cp>In a statement following the veto, Menjivar pledged to hold the administration accountable.\u003c/p>\n\u003cp>Wonderly, the mom of four, said it took 14 months for her eldest daughter Cassie’s hearing loss to get diagnosed. She worried that Cassie, who didn’t respond to sound and who had the limited eyesight normal for newborns, wouldn’t know who her parents were.\u003c/p>\n\u003cp>“Every night I fell asleep with my hand on my baby because I wanted her to know that she was secure, she was safe. That she knew that we were there for her,” Wonderly said.\u003c/p>\n\u003cp>Wonderly said eventually the national grant program paid for her second daughter’s hearing aids. But soon Cassie, now 9, will need an updated pair, and Wonderly’s two other children, ages 7 and 1, who also have hearing loss, will likely need hearing aids in the future.\u003c/p>\n\u003cp>The closest provider that participates in the Hearing Aid Coverage for Children Program is more than 100 miles away, Wonderly said.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>Supported by the California Health Care Foundation (CHCF), which works to ensure that people have access to the care they need, when they need it, at a price they can afford. Visit \u003ca href=\"http://www.chcf.org/\">www.chcf.org\u003c/a> to learn more.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/news/11964609/families-fume-over-newsoms-veto-of-childrens-hearing-aid-bill","authors":["byline_news_11964609"],"categories":["news_8"],"tags":["news_21845","news_27626","news_25015","news_33341","news_33340","news_2605"],"affiliates":["news_18481"],"featImg":"news_11964610","label":"news_18481"},"news_11961346":{"type":"posts","id":"news_11961346","meta":{"index":"posts_1591205157","site":"news","id":"11961346","score":null,"sort":[1694874610000]},"guestAuthors":[],"slug":"gavin-newsoms-mental-health-plan-heads-to-voters-heres-what-to-know","title":"Gavin Newsom's Mental Health Plan Heads to Voters. Here's What to Know","publishDate":1694874610,"format":"standard","headTitle":"Gavin Newsom’s Mental Health Plan Heads to Voters. Here’s What to Know | KQED","labelTerm":{"term":18481,"site":"news"},"content":"\u003cp>California voters next spring will get to decide on a ballot measure to create housing and treatment options for unhoused individuals with serious mental illness. If it passes, the measure championed by Gov. Gavin Newsom would mark the first major overhaul of the state’s community mental health system in 20 years.\u003c/p>\n\u003cp>The two-pronged proposition on the March primary election ballot includes a nearly $6.4 billion bond to build 10,000 psychiatric treatment units. It also asks voters to redefine how counties spend money collected from a special “millionaire’s tax” to allocate a share of it for housing.\u003c/p>\n\u003cp>Newsom and supporters have promoted Proposition 1 as a way to help address the state’s deteriorating homelessness and addiction crises. They contend that increased investment and an update to the state’s Mental Health Services Act are “long overdue.”\u003c/p>\n\u003cp>The Legislature on Thursday overwhelmingly backed his proposal, with lopsided votes to place it on the 2024 ballot. Newsom still must sign the bills, and he said he would in a written statement after a late-night vote in the Assembly.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“These measures represent a key part of the solution to our homelessness crisis, and improving mental health for kids and families,” Newsom said. “Now, it will be up to voters to ratify the most significant changes to California’s mental health system in more than 50 years.”\u003c/p>\n\u003cp>Opponents of the ballot measure say diverting money in the Mental Health Services Act for housing will result in up to $1 billion in cuts to\u003ca href=\"https://lao.ca.gov/Publications/Report/4782\"> current mental health programs\u003c/a> like outpatient care and crisis response. Other advocates criticize the governor for making last-minute changes to the bond, allowing the money to be spent on involuntary treatment institutions.\u003c/p>\n\u003cp>So what exactly are voters being asked to consider? Here’s how the proposal breaks down.\u003c/p>\n\u003ch2>What is the Mental Health Services Act?\u003c/h2>\n\u003cp>The Mental Health Services Act, which voters passed as a ballot measure in 2004, levies a 1% tax on personal income over $1 million. It passed at a time when the state’s mental health system was severely underfunded. Since then, the tax has generated an estimated $26 billion for county mental health programs. Last year the tax garnered more than $3 billion. It supports roughly one-third of the state’s mental health system. [pullquote size=\"medium\" align=\"right\" citation=\"Gov. Gavin Newsom\"]‘These measures represent a key part of the solution to our homelessness crisis, and improving mental health for kids and families.’[/pullquote] The tax is not California’s only source of revenue for mental health programs. The state also receives money from Medi-Cal, and it spends a portion of its general fund on those services. Those sources come with strict spending limitations. For example, Medi-Cal primarily pays for treatment of mental health disorders but will not cover prevention programs. It also will not pay for inpatient treatment at a facility with more than 16 beds.\u003c/p>\n\u003cp>Counties have come to rely on the relative flexibility of Mental Health Services Act dollars to pay for core services like outpatient care, outreach and engagement, school-based counseling, youth wellness programs, family resource centers, and crisis response teams.\u003c/p>\n\u003ch2>What does Newsom want to do?\u003c/h2>\n\u003cp>The most significant change put forth by the governor is a requirement that counties invest 30% of their Mental Health Services Act tax dollars — roughly $1 billion based on last year’s revenue — in housing programs, including rental subsidies and navigation services. Counties would have to spend half this money on people who are chronically homeless or living in encampments. They could also use up to one-quarter of the money to build or purchase housing units.\u003c/p>\n\u003cp>Sacramento Mayor Darrell Steinberg has been a staunch supporter of Newsom’s proposal. Steinberg was one of the co-authors of the Mental Health Services Act when he was an Assembly member in 2004.\u003c/p>\n\u003cp>“To put it plainly, not enough of the Mental Health Services Act dollars are getting out to the people with the most persistent mental illnesses, specifically people who are chronically homeless and living with those underlying conditions,” Steinberg said during a press call in August. “So that’s where you start.”\u003c/p>\n\u003cp>The ballot measure puts counties on the hook for paying for substance use disorder treatment with Mental Health Services Act money. Counties have historically paid for addiction treatment with other funding.\u003c/p>\n\u003cp>And, it\u003cstrong> \u003c/strong>renames the program as the Behavioral Health Services Act.\u003c/p>\n\u003cfigure id=\"attachment_11961360\" class=\"wp-caption aligncenter\" style=\"max-width: 2400px\">\u003cimg decoding=\"async\" loading=\"lazy\" class=\"size-full wp-image-11961360\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/09/CMNewsom02.jpeg\" alt=\"Gov. Gavin Newsom is pictured with his hands out as he speak to many folks in a warehouse in front of a microphone.\" width=\"2400\" height=\"1600\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2023/09/CMNewsom02.jpeg 2400w, https://ww2.kqed.org/app/uploads/sites/10/2023/09/CMNewsom02-800x533.jpeg 800w, https://ww2.kqed.org/app/uploads/sites/10/2023/09/CMNewsom02-1020x680.jpeg 1020w, https://ww2.kqed.org/app/uploads/sites/10/2023/09/CMNewsom02-160x107.jpeg 160w, https://ww2.kqed.org/app/uploads/sites/10/2023/09/CMNewsom02-1536x1024.jpeg 1536w, https://ww2.kqed.org/app/uploads/sites/10/2023/09/CMNewsom02-2048x1365.jpeg 2048w, https://ww2.kqed.org/app/uploads/sites/10/2023/09/CMNewsom02-1920x1280.jpeg 1920w\" sizes=\"(max-width: 2400px) 100vw, 2400px\">\u003cfigcaption class=\"wp-caption-text\">Flanked by state and local politicians, Newsom announced the state’s plan to address homelessness across the state at Cal Expo in Sacramento, on March 16, 2023. \u003ccite>(Miguel Gutierrez Jr./CalMatters)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003ch2>What will the bond measure do?\u003c/h2>\n\u003cp>The second half of Newsom’s proposal places a $6.4 billion general obligation bond before voters to dramatically expand the state’s psychiatric and addiction treatment infrastructure. [pullquote size=\"medium\" align=\"right\" citation=\"Sacramento Mayor Darrell Steinberg\"]‘To put it plainly, not enough of the Mental Health Services Act dollars are getting out to the people with the most persistent mental illnesses, specifically people who are chronically homeless and living with those underlying conditions.’[/pullquote] Nearly $4.4 billion would go toward building inpatient and residential treatment beds and could serve 100,000 people annually, officials said. California faces a shortage of \u003ca href=\"https://www.rand.org/content/dam/rand/pubs/testimonies/CTA2700/CTA2742-1/RAND_CTA2742-1.pdf\">nearly 8,000 adult psychiatric beds (PDF)\u003c/a>, said Nicole Eberhart, senior behavioral health scientist for the RAND Corporation, during testimony to an Assembly budget subcommittee in May. Long waitlists plague the state’s inpatient mental health system, and doctors say there’s nowhere to send stable patients who need long-term treatment focused on recovery.\u003c/p>\n\u003cp>Another $2 billion will go toward building permanent supportive housing, with half set aside for veterans with mental health diagnoses or addiction disorders.\u003c/p>\n\u003ch2>How many people are unhoused in California?\u003c/h2>\n\u003cp>More than 170,000 Californians are unhoused, the vast majority of whom live in street encampments. California has the highest homeless rate per 10,000 people, second only to the District of Columbia, and the highest proportion of unsheltered homeless individuals in the country, according to federal data.\u003c/p>\n\u003cp>A \u003ca href=\"https://calmatters.org/housing/2023/06/california-homeless-growth-report/\">landmark study by the UCSF Benioff Homelessness and Housing Initiative\u003c/a> found about two-thirds of unhoused Californians surveyed suffered from a mental health disorder but only 19% had received recent treatment. The driving force behind homelessness, however, was most often income loss, not mental illness or addiction, \u003ca href=\"https://homelessness.ucsf.edu/our-impact/our-studies/california-statewide-study-people-experiencing-homelessness\">according to the study\u003c/a>. [aside label='More Around California' tag='california-law']\u003c/p>\n\u003ch2>Who are the supporters?\u003c/h2>\n\u003cp>Sen. Susan Talamantes-Eggman, a Democrat from Stockton, carried the proposed reform of the Mental Health Services Act in the Legislature. During Thursday’s Senate concurrence vote, Talamantes-Eggman said the way counties spend state mental health funding needs to address changes that have happened in the two decades since the act was first designed.\u003c/p>\n\u003cp>Assemblymember Jacqui Irwin, a Democrat from Thousand Oaks, carried the bond proposal in the Legislature.\u003c/p>\n\u003cp>Mayors and county supervisors from eight major regions, including San Francisco and Los Angeles, successfully lobbied to increase funding for the bond measure by $1.5 billion. City leaders were early supporters of the measure with more than two dozen submitting letters of support along with housing and homeless advocates and the National Alliance on Mental Illness California.\u003c/p>\n\u003ch2>Who are the opponents?\u003c/h2>\n\u003cp>Peer-run and disability organizations have been the staunchest opponents of the changes proposed in the ballot measure. They argue current clients will lose treatment options and accuse Newsom’s administration of using the proposal to fund his \u003ca href=\"https://calmatters.org/housing/2023/08/care-court-california-start/\">CARE Court initiative\u003c/a> that passed last year. That law allows a court to place someone with a serious mental illness into an involuntary treatment program. [pullquote size=\"medium\" align=\"right\" citation=\"Paul Simmons, executive director, Depression and Bipolar Support Alliance\"]‘This is a really tough time for our communities. Our concern with [the proposition] is massive increases in involuntary and forced treatment.’[/pullquote] Groups representing people of color and LGBTQ+ communities also oppose the measure. They say it will eliminate prevention resources and worsen already stark disparities in access to treatment. Resource centers that target these populations are among the services most likely to get cut, county behavioral health leaders have said in public hearing.\u003c/p>\n\u003cp>The bond measure, which previously faced no opposition, drew fierce criticism from peer and disability advocates after last-minute amendments \u003ca href=\"https://calmatters.org/health/mental-health/2023/09/mental-health-bond-gavin-newsom-amendments/\">allowed the money to be used on involuntary treatment facilities\u003c/a>.\u003c/p>\n\u003cp>“This is a really tough time for our communities,” said Paul Simmons, executive director of the Depression and Bipolar Support Alliance. “Our concern with [the proposition] is massive increases in involuntary and forced treatment.”\u003c/p>\n\u003cp>Children and family advocates withdrew previous opposition after securing significant concessions from the governor requiring 51% of spending on early intervention be targeted toward children and youth.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n","blocks":[],"excerpt":"Some of the money from a state tax on high incomes supporting mental health services will aid housing for those experiencing homelessness and mental illness. ","status":"publish","parent":0,"modified":1694812702,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":27,"wordCount":1509},"headData":{"title":"Gavin Newsom's Mental Health Plan Heads to Voters. Here's What to Know | KQED","description":"Some of the money from a state tax on high incomes supporting mental health services will aid housing for those experiencing homelessness and mental illness. ","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":""},"nprByline":"\u003ca href=\"https://calmatters.org/author/kristen-hwang/\">Kristen Hwang\u003c/a>","excludeFromSiteSearch":"Include","showOnAuthorArchivePages":"No","articleAge":"0","path":"/news/11961346/gavin-newsoms-mental-health-plan-heads-to-voters-heres-what-to-know","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>California voters next spring will get to decide on a ballot measure to create housing and treatment options for unhoused individuals with serious mental illness. If it passes, the measure championed by Gov. Gavin Newsom would mark the first major overhaul of the state’s community mental health system in 20 years.\u003c/p>\n\u003cp>The two-pronged proposition on the March primary election ballot includes a nearly $6.4 billion bond to build 10,000 psychiatric treatment units. It also asks voters to redefine how counties spend money collected from a special “millionaire’s tax” to allocate a share of it for housing.\u003c/p>\n\u003cp>Newsom and supporters have promoted Proposition 1 as a way to help address the state’s deteriorating homelessness and addiction crises. They contend that increased investment and an update to the state’s Mental Health Services Act are “long overdue.”\u003c/p>\n\u003cp>The Legislature on Thursday overwhelmingly backed his proposal, with lopsided votes to place it on the 2024 ballot. Newsom still must sign the bills, and he said he would in a written statement after a late-night vote in the Assembly.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“These measures represent a key part of the solution to our homelessness crisis, and improving mental health for kids and families,” Newsom said. “Now, it will be up to voters to ratify the most significant changes to California’s mental health system in more than 50 years.”\u003c/p>\n\u003cp>Opponents of the ballot measure say diverting money in the Mental Health Services Act for housing will result in up to $1 billion in cuts to\u003ca href=\"https://lao.ca.gov/Publications/Report/4782\"> current mental health programs\u003c/a> like outpatient care and crisis response. Other advocates criticize the governor for making last-minute changes to the bond, allowing the money to be spent on involuntary treatment institutions.\u003c/p>\n\u003cp>So what exactly are voters being asked to consider? Here’s how the proposal breaks down.\u003c/p>\n\u003ch2>What is the Mental Health Services Act?\u003c/h2>\n\u003cp>The Mental Health Services Act, which voters passed as a ballot measure in 2004, levies a 1% tax on personal income over $1 million. It passed at a time when the state’s mental health system was severely underfunded. Since then, the tax has generated an estimated $26 billion for county mental health programs. Last year the tax garnered more than $3 billion. It supports roughly one-third of the state’s mental health system. \u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"‘These measures represent a key part of the solution to our homelessness crisis, and improving mental health for kids and families.’","name":"pullquote","attributes":{"named":{"size":"medium","align":"right","citation":"Gov. Gavin Newsom","label":""},"numeric":[]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp> The tax is not California’s only source of revenue for mental health programs. The state also receives money from Medi-Cal, and it spends a portion of its general fund on those services. Those sources come with strict spending limitations. For example, Medi-Cal primarily pays for treatment of mental health disorders but will not cover prevention programs. It also will not pay for inpatient treatment at a facility with more than 16 beds.\u003c/p>\n\u003cp>Counties have come to rely on the relative flexibility of Mental Health Services Act dollars to pay for core services like outpatient care, outreach and engagement, school-based counseling, youth wellness programs, family resource centers, and crisis response teams.\u003c/p>\n\u003ch2>What does Newsom want to do?\u003c/h2>\n\u003cp>The most significant change put forth by the governor is a requirement that counties invest 30% of their Mental Health Services Act tax dollars — roughly $1 billion based on last year’s revenue — in housing programs, including rental subsidies and navigation services. Counties would have to spend half this money on people who are chronically homeless or living in encampments. They could also use up to one-quarter of the money to build or purchase housing units.\u003c/p>\n\u003cp>Sacramento Mayor Darrell Steinberg has been a staunch supporter of Newsom’s proposal. Steinberg was one of the co-authors of the Mental Health Services Act when he was an Assembly member in 2004.\u003c/p>\n\u003cp>“To put it plainly, not enough of the Mental Health Services Act dollars are getting out to the people with the most persistent mental illnesses, specifically people who are chronically homeless and living with those underlying conditions,” Steinberg said during a press call in August. “So that’s where you start.”\u003c/p>\n\u003cp>The ballot measure puts counties on the hook for paying for substance use disorder treatment with Mental Health Services Act money. Counties have historically paid for addiction treatment with other funding.\u003c/p>\n\u003cp>And, it\u003cstrong> \u003c/strong>renames the program as the Behavioral Health Services Act.\u003c/p>\n\u003cfigure id=\"attachment_11961360\" class=\"wp-caption aligncenter\" style=\"max-width: 2400px\">\u003cimg decoding=\"async\" loading=\"lazy\" class=\"size-full wp-image-11961360\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/09/CMNewsom02.jpeg\" alt=\"Gov. Gavin Newsom is pictured with his hands out as he speak to many folks in a warehouse in front of a microphone.\" width=\"2400\" height=\"1600\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2023/09/CMNewsom02.jpeg 2400w, https://ww2.kqed.org/app/uploads/sites/10/2023/09/CMNewsom02-800x533.jpeg 800w, https://ww2.kqed.org/app/uploads/sites/10/2023/09/CMNewsom02-1020x680.jpeg 1020w, https://ww2.kqed.org/app/uploads/sites/10/2023/09/CMNewsom02-160x107.jpeg 160w, https://ww2.kqed.org/app/uploads/sites/10/2023/09/CMNewsom02-1536x1024.jpeg 1536w, https://ww2.kqed.org/app/uploads/sites/10/2023/09/CMNewsom02-2048x1365.jpeg 2048w, https://ww2.kqed.org/app/uploads/sites/10/2023/09/CMNewsom02-1920x1280.jpeg 1920w\" sizes=\"(max-width: 2400px) 100vw, 2400px\">\u003cfigcaption class=\"wp-caption-text\">Flanked by state and local politicians, Newsom announced the state’s plan to address homelessness across the state at Cal Expo in Sacramento, on March 16, 2023. \u003ccite>(Miguel Gutierrez Jr./CalMatters)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003ch2>What will the bond measure do?\u003c/h2>\n\u003cp>The second half of Newsom’s proposal places a $6.4 billion general obligation bond before voters to dramatically expand the state’s psychiatric and addiction treatment infrastructure. \u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"‘To put it plainly, not enough of the Mental Health Services Act dollars are getting out to the people with the most persistent mental illnesses, specifically people who are chronically homeless and living with those underlying conditions.’","name":"pullquote","attributes":{"named":{"size":"medium","align":"right","citation":"Sacramento Mayor Darrell Steinberg","label":""},"numeric":[]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp> Nearly $4.4 billion would go toward building inpatient and residential treatment beds and could serve 100,000 people annually, officials said. California faces a shortage of \u003ca href=\"https://www.rand.org/content/dam/rand/pubs/testimonies/CTA2700/CTA2742-1/RAND_CTA2742-1.pdf\">nearly 8,000 adult psychiatric beds (PDF)\u003c/a>, said Nicole Eberhart, senior behavioral health scientist for the RAND Corporation, during testimony to an Assembly budget subcommittee in May. Long waitlists plague the state’s inpatient mental health system, and doctors say there’s nowhere to send stable patients who need long-term treatment focused on recovery.\u003c/p>\n\u003cp>Another $2 billion will go toward building permanent supportive housing, with half set aside for veterans with mental health diagnoses or addiction disorders.\u003c/p>\n\u003ch2>How many people are unhoused in California?\u003c/h2>\n\u003cp>More than 170,000 Californians are unhoused, the vast majority of whom live in street encampments. California has the highest homeless rate per 10,000 people, second only to the District of Columbia, and the highest proportion of unsheltered homeless individuals in the country, according to federal data.\u003c/p>\n\u003cp>A \u003ca href=\"https://calmatters.org/housing/2023/06/california-homeless-growth-report/\">landmark study by the UCSF Benioff Homelessness and Housing Initiative\u003c/a> found about two-thirds of unhoused Californians surveyed suffered from a mental health disorder but only 19% had received recent treatment. The driving force behind homelessness, however, was most often income loss, not mental illness or addiction, \u003ca href=\"https://homelessness.ucsf.edu/our-impact/our-studies/california-statewide-study-people-experiencing-homelessness\">according to the study\u003c/a>. \u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"aside","attributes":{"named":{"label":"More Around California ","tag":"california-law"},"numeric":[]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003ch2>Who are the supporters?\u003c/h2>\n\u003cp>Sen. Susan Talamantes-Eggman, a Democrat from Stockton, carried the proposed reform of the Mental Health Services Act in the Legislature. During Thursday’s Senate concurrence vote, Talamantes-Eggman said the way counties spend state mental health funding needs to address changes that have happened in the two decades since the act was first designed.\u003c/p>\n\u003cp>Assemblymember Jacqui Irwin, a Democrat from Thousand Oaks, carried the bond proposal in the Legislature.\u003c/p>\n\u003cp>Mayors and county supervisors from eight major regions, including San Francisco and Los Angeles, successfully lobbied to increase funding for the bond measure by $1.5 billion. City leaders were early supporters of the measure with more than two dozen submitting letters of support along with housing and homeless advocates and the National Alliance on Mental Illness California.\u003c/p>\n\u003ch2>Who are the opponents?\u003c/h2>\n\u003cp>Peer-run and disability organizations have been the staunchest opponents of the changes proposed in the ballot measure. They argue current clients will lose treatment options and accuse Newsom’s administration of using the proposal to fund his \u003ca href=\"https://calmatters.org/housing/2023/08/care-court-california-start/\">CARE Court initiative\u003c/a> that passed last year. That law allows a court to place someone with a serious mental illness into an involuntary treatment program. \u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"‘This is a really tough time for our communities. Our concern with [the proposition] is massive increases in involuntary and forced treatment.’","name":"pullquote","attributes":{"named":{"size":"medium","align":"right","citation":"Paul Simmons, executive director, Depression and Bipolar Support Alliance","label":""},"numeric":[]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp> Groups representing people of color and LGBTQ+ communities also oppose the measure. They say it will eliminate prevention resources and worsen already stark disparities in access to treatment. Resource centers that target these populations are among the services most likely to get cut, county behavioral health leaders have said in public hearing.\u003c/p>\n\u003cp>The bond measure, which previously faced no opposition, drew fierce criticism from peer and disability advocates after last-minute amendments \u003ca href=\"https://calmatters.org/health/mental-health/2023/09/mental-health-bond-gavin-newsom-amendments/\">allowed the money to be used on involuntary treatment facilities\u003c/a>.\u003c/p>\n\u003cp>“This is a really tough time for our communities,” said Paul Simmons, executive director of the Depression and Bipolar Support Alliance. “Our concern with [the proposition] is massive increases in involuntary and forced treatment.”\u003c/p>\n\u003cp>Children and family advocates withdrew previous opposition after securing significant concessions from the governor requiring 51% of spending on early intervention be targeted toward children and youth.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/news/11961346/gavin-newsoms-mental-health-plan-heads-to-voters-heres-what-to-know","authors":["byline_news_11961346"],"categories":["news_31795","news_8"],"tags":["news_16","news_20305","news_1775","news_2605","news_31651","news_31453","news_33195","news_31538","news_30602"],"affiliates":["news_18481"],"featImg":"news_11961358","label":"news_18481"},"news_11950092":{"type":"posts","id":"news_11950092","meta":{"index":"posts_1591205157","site":"news","id":"11950092","score":null,"sort":[1684455304000]},"guestAuthors":[],"slug":"san-francisco-laguna-honda-hospital-granted-extension","title":"Feds Grant SF’s Laguna Honda Hospital New Extension, Delaying Involuntary Patient Transfers","publishDate":1684455304,"format":"standard","headTitle":"Feds Grant SF’s Laguna Honda Hospital New Extension, Delaying Involuntary Patient Transfers | KQED","labelTerm":{"site":"news"},"content":"\u003cp>Federal regulators have agreed to again put off involuntarily transferring residents at \u003ca href=\"https://www.kqed.org/news/11939987/feds-grant-reprieve-on-laguna-honda-patient-transfers-until-may\">Laguna Honda\u003c/a>, the state’s largest public nursing facility, which fell out of compliance in 2022.\u003c/p>\n\u003cp>The reprieve came just one day before the hospital would have been forced to implement a closure plan that involves assessing and discharging the facility’s more than 500 medically fragile patients in preparation for a possible closure.\u003c/p>\n\u003cp>Laguna Honda now has until Sept. 19, 2023, before involuntary transfers could resume, according to a letter from interim CEO Roland Pickens. In addition, health insurance coverage for the hospital’s majority of patients who are on Medi-Cal and Medicare will continue through March 19, 2024.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“Today’s good news is the result of positive changes taking place at Laguna Honda,” said Pickens in a note to families on Thursday. “The additional time provided by the extension allows us the opportunity we need [to] be in the best position to apply for recertification.”\u003c/p>\n\u003cp>The hospital is now working to regain certification with the Centers for Medicare and Medicaid Services, the federal regulatory body that Laguna Honda fell out of compliance with in April 2022.\u003c/p>\n\u003cp>[pullquote size=\"medium\" align=\"right\" citation=\"Roland Pickens, interim CEO, Laguna Honda Hospital\"]‘The additional time provided by the extension allows us the opportunity we need [to] be in the best position to apply for recertification.’[/pullquote]\u003c/p>\n\u003cp>The hospital was cited for a number of safety issues across multiple regulatory surveys that were triggered after \u003ca href=\"https://www.kqed.org/news/11949515/laguna-honda-faces-covid-outbreak-amid-looming-patient-transfer-deadline\">Laguna Honda self-reported two nonfatal overdoses\u003c/a> that occurred on-site.\u003c/p>\n\u003cp>As a result, federal regulators stripped Laguna Honda from Medicare and Medi-Cal, subsidized health care plans that cover the vast majority of residents at the facility, most of whom have extremely low incomes.\u003c/p>\n\u003cp>While Laguna Honda works to address its citations, CMS has simultaneously required that the hospital craft a closure plan to continue its health care funding. That plan involved assessing and relocating as many patients as possible in 2022.\u003c/p>\n\u003cfigure id=\"attachment_11950111\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg decoding=\"async\" loading=\"lazy\" class=\"size-full wp-image-11950111\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/05/RS62460_007_KQED_LagunaHondaHospital_01312023-qut.jpg\" alt='An outdoor shot of a big tan hospital building surrounded by tall trees, succulents and other green plants. The words \"Laguna Honda Hospital\" are seen over the main entryway.' width=\"1920\" height=\"1280\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2023/05/RS62460_007_KQED_LagunaHondaHospital_01312023-qut.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/10/2023/05/RS62460_007_KQED_LagunaHondaHospital_01312023-qut-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/10/2023/05/RS62460_007_KQED_LagunaHondaHospital_01312023-qut-1020x680.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/10/2023/05/RS62460_007_KQED_LagunaHondaHospital_01312023-qut-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/10/2023/05/RS62460_007_KQED_LagunaHondaHospital_01312023-qut-1536x1024.jpg 1536w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">The Laguna Honda Hospital administration building in San Francisco on Jan. 31, 2023. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Of 57 residents who were transferred or discharged during that process, 12 died shortly after their relocations. The city sued the federal government in response, and the transfer process was paused temporarily as part of a settlement agreement.\u003c/p>\n\u003cp>“Involuntary transfers caused our residents, their families, and our staff a great deal of distress. Laguna Honda and City leadership, as well as residents, families, and advocates, have strongly advocated against the involuntary transfers,” a spokesperson for the hospital wrote Tuesday in a media release. “This is the humane and compassionate path forward for our residents, their families, our staff, and all those who care about Laguna Honda.”\u003c/p>\n\u003cp>Following the city’s lawsuit in November 2022, the city and CMS reached a settlement agreement to pause the involuntary transfers until February 2023 and to continue health care payments through November 2023.\u003c/p>\n\u003cp>In February 2023, regulators agreed to extend the pause on transfers to May 19.\u003c/p>\n\u003cp>Today’s update moves the deadline yet again to Sept. 19, 2023, and payments will continue through March 19, 2024.[pullquote size=\"medium\" align=\"right\" citation=\"City Attorney David Chiu\"]‘The city and Laguna Honda have done a tremendous amount of work to come into compliance with the hundreds of requirements that have been asked of us and we believe we are in a good spot.’[/pullquote]“The city and Laguna Honda have done a tremendous amount of work to come into compliance with the hundreds of requirements that have been asked of us and we believe we are in a good spot,” said City Attorney David Chiu, whose office led the lawsuit against the federal regulators in 2022.\u003c/p>\n\u003cp>The hospital can apply for recertification after it successfully completes its next monitoring survey with CMS, which hospital officials say they expect to happen by the end of May or in June of this year.\u003c/p>\n\u003cp>“Laguna Honda is working diligently to make and sustain improvements that will serve our current residents and ensure Laguna Honda remains an essential part of the City and County of San Francisco’s commitment to public health,” the spokesperson said. “We remain confident that Laguna Honda is the best place for our residents to receive care.”[aside postID=news_11940765 hero='https://ww2.kqed.org/app/uploads/sites/10/2023/02/RS62526_02022023_lagunahondapresser-308-qut-1-1020x678.jpg']Meanwhile, senior and disability advocates have raised the alarm over the back-and-forth messaging that the hospital’s more than 500 residents and their families have endured throughout the regulatory spiral.\u003c/p>\n\u003cp>“Resuming evictions or whatever you want to call them is extremely dangerous,” said Teresa Palmer, who previously worked at Laguna Honda, in a recent town hall meeting about patients’ rights ahead of the looming discharges. “I don’t see how evictions and transfers can be resumed without severe consequences, not only to patients, but to the government agencies that are forcing them.”\u003c/p>\n\u003cp>\u003c/p>\n","blocks":[],"excerpt":"'Today’s good news is the result of positive changes taking place at Laguna Honda,' said interim CEO Roland Pickens.","status":"publish","parent":0,"modified":1684797885,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":19,"wordCount":856},"headData":{"title":"Feds Grant SF’s Laguna Honda Hospital New Extension, Delaying Involuntary Patient Transfers | KQED","description":"'Today’s good news is the result of positive changes taking place at Laguna Honda,' said interim CEO Roland Pickens.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":""},"excludeFromSiteSearch":"Include","articleAge":"0","path":"/news/11950092/san-francisco-laguna-honda-hospital-granted-extension","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Federal regulators have agreed to again put off involuntarily transferring residents at \u003ca href=\"https://www.kqed.org/news/11939987/feds-grant-reprieve-on-laguna-honda-patient-transfers-until-may\">Laguna Honda\u003c/a>, the state’s largest public nursing facility, which fell out of compliance in 2022.\u003c/p>\n\u003cp>The reprieve came just one day before the hospital would have been forced to implement a closure plan that involves assessing and discharging the facility’s more than 500 medically fragile patients in preparation for a possible closure.\u003c/p>\n\u003cp>Laguna Honda now has until Sept. 19, 2023, before involuntary transfers could resume, according to a letter from interim CEO Roland Pickens. In addition, health insurance coverage for the hospital’s majority of patients who are on Medi-Cal and Medicare will continue through March 19, 2024.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“Today’s good news is the result of positive changes taking place at Laguna Honda,” said Pickens in a note to families on Thursday. “The additional time provided by the extension allows us the opportunity we need [to] be in the best position to apply for recertification.”\u003c/p>\n\u003cp>The hospital is now working to regain certification with the Centers for Medicare and Medicaid Services, the federal regulatory body that Laguna Honda fell out of compliance with in April 2022.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"‘The additional time provided by the extension allows us the opportunity we need [to] be in the best position to apply for recertification.’","name":"pullquote","attributes":{"named":{"size":"medium","align":"right","citation":"Roland Pickens, interim CEO, Laguna Honda Hospital","label":""},"numeric":[]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The hospital was cited for a number of safety issues across multiple regulatory surveys that were triggered after \u003ca href=\"https://www.kqed.org/news/11949515/laguna-honda-faces-covid-outbreak-amid-looming-patient-transfer-deadline\">Laguna Honda self-reported two nonfatal overdoses\u003c/a> that occurred on-site.\u003c/p>\n\u003cp>As a result, federal regulators stripped Laguna Honda from Medicare and Medi-Cal, subsidized health care plans that cover the vast majority of residents at the facility, most of whom have extremely low incomes.\u003c/p>\n\u003cp>While Laguna Honda works to address its citations, CMS has simultaneously required that the hospital craft a closure plan to continue its health care funding. That plan involved assessing and relocating as many patients as possible in 2022.\u003c/p>\n\u003cfigure id=\"attachment_11950111\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg decoding=\"async\" loading=\"lazy\" class=\"size-full wp-image-11950111\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/05/RS62460_007_KQED_LagunaHondaHospital_01312023-qut.jpg\" alt='An outdoor shot of a big tan hospital building surrounded by tall trees, succulents and other green plants. The words \"Laguna Honda Hospital\" are seen over the main entryway.' width=\"1920\" height=\"1280\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2023/05/RS62460_007_KQED_LagunaHondaHospital_01312023-qut.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/10/2023/05/RS62460_007_KQED_LagunaHondaHospital_01312023-qut-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/10/2023/05/RS62460_007_KQED_LagunaHondaHospital_01312023-qut-1020x680.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/10/2023/05/RS62460_007_KQED_LagunaHondaHospital_01312023-qut-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/10/2023/05/RS62460_007_KQED_LagunaHondaHospital_01312023-qut-1536x1024.jpg 1536w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">The Laguna Honda Hospital administration building in San Francisco on Jan. 31, 2023. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Of 57 residents who were transferred or discharged during that process, 12 died shortly after their relocations. The city sued the federal government in response, and the transfer process was paused temporarily as part of a settlement agreement.\u003c/p>\n\u003cp>“Involuntary transfers caused our residents, their families, and our staff a great deal of distress. Laguna Honda and City leadership, as well as residents, families, and advocates, have strongly advocated against the involuntary transfers,” a spokesperson for the hospital wrote Tuesday in a media release. “This is the humane and compassionate path forward for our residents, their families, our staff, and all those who care about Laguna Honda.”\u003c/p>\n\u003cp>Following the city’s lawsuit in November 2022, the city and CMS reached a settlement agreement to pause the involuntary transfers until February 2023 and to continue health care payments through November 2023.\u003c/p>\n\u003cp>In February 2023, regulators agreed to extend the pause on transfers to May 19.\u003c/p>\n\u003cp>Today’s update moves the deadline yet again to Sept. 19, 2023, and payments will continue through March 19, 2024.\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"‘The city and Laguna Honda have done a tremendous amount of work to come into compliance with the hundreds of requirements that have been asked of us and we believe we are in a good spot.’","name":"pullquote","attributes":{"named":{"size":"medium","align":"right","citation":"City Attorney David Chiu","label":""},"numeric":[]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>“The city and Laguna Honda have done a tremendous amount of work to come into compliance with the hundreds of requirements that have been asked of us and we believe we are in a good spot,” said City Attorney David Chiu, whose office led the lawsuit against the federal regulators in 2022.\u003c/p>\n\u003cp>The hospital can apply for recertification after it successfully completes its next monitoring survey with CMS, which hospital officials say they expect to happen by the end of May or in June of this year.\u003c/p>\n\u003cp>“Laguna Honda is working diligently to make and sustain improvements that will serve our current residents and ensure Laguna Honda remains an essential part of the City and County of San Francisco’s commitment to public health,” the spokesperson said. “We remain confident that Laguna Honda is the best place for our residents to receive care.”\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"aside","attributes":{"named":{"postid":"news_11940765","hero":"https://ww2.kqed.org/app/uploads/sites/10/2023/02/RS62526_02022023_lagunahondapresser-308-qut-1-1020x678.jpg","label":""},"numeric":[]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>Meanwhile, senior and disability advocates have raised the alarm over the back-and-forth messaging that the hospital’s more than 500 residents and their families have endured throughout the regulatory spiral.\u003c/p>\n\u003cp>“Resuming evictions or whatever you want to call them is extremely dangerous,” said Teresa Palmer, who previously worked at Laguna Honda, in a recent town hall meeting about patients’ rights ahead of the looming discharges. “I don’t see how evictions and transfers can be resumed without severe consequences, not only to patients, but to the government agencies that are forcing them.”\u003c/p>\n\u003cp>\u003c/p>\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/news/11950092/san-francisco-laguna-honda-hospital-granted-extension","authors":["11840"],"categories":["news_457","news_8"],"tags":["news_21352","news_27626","news_683","news_32402","news_26092","news_2605","news_26763"],"featImg":"news_11950108","label":"news"},"news_11944613":{"type":"posts","id":"news_11944613","meta":{"index":"posts_1591205157","site":"news","id":"11944613","score":null,"sort":[1679693057000]},"guestAuthors":[],"slug":"gov-newsoms-prescription-housing-plan-would-cover-6-months-rent-through-medi-cal","title":"Gov. Newsom's Prescription Housing Plan Would Cover 6 Months' Rent Through Medi-Cal","publishDate":1679693057,"format":"standard","headTitle":"California Healthline | KQED News","labelTerm":{"term":20286,"site":"news"},"content":"\u003cp>Gov. Gavin Newsom, whose administration is struggling to contain a worsening homelessness crisis despite \u003ca href=\"https://khn.org/news/article/california-homeless-crisis-governor-gavin-newsom-political-future/\">record spending\u003c/a>, is trying something bold: tapping federal health care funding to cover rent for unhoused people and those at risk of losing their housing.\u003c/p>\n\u003cp>States are barred from using federal Medicaid dollars to pay directly for rent, but California’s governor is asking the administration of President Joe Biden, a fellow Democrat, to authorize a new program called “\u003ca href=\"https://ebudget.ca.gov/2023-24/pdf/BudgetSummary/HealthandHumanServices.pdf\">transitional rent (PDF)\u003c/a>,” which would provide up to six months of rent or temporary housing for\u003ca href=\"https://khn.org/news/article/californias-massive-medicaid-program-works-for-some-but-fails-many-others/\"> enrollees with \u003c/a>\u003ca href=\"https://khn.org/news/article/californias-massive-medicaid-program-works-for-some-but-fails-many-others/\">lower incomes\u003c/a> who rely on the state’s health care safety net — a new initiative to fight and prevent homelessness.\u003c/p>\n\u003cp>“I’ve been talking to the president. We cannot do this alone,” Newsom told California Healthline.\u003c/p>\n\u003cp>The governor is pushing California’s version of Medicaid, called Medi-Cal, to fund experimental housing subsidies for people experiencing homelessness, betting that it’s cheaper for taxpayers to cover rent than to allow people to fall into crisis or costly institutional care in hospitals, nursing homes and jails. Early in his tenure, \u003ca href=\"https://www.gov.ca.gov/2020/02/19/governor-newsom-delivers-state-of-the-state-address-on-homelessness/\">Newsom proclaimed\u003c/a> that “doctors should be able to write prescriptions for housing the same way they do for insulin or antibiotics.”\u003c/p>\n\u003cp>But it’s a risky endeavor in a high-cost state where \u003ca href=\"https://www.zillow.com/rental-manager/market-trends/ca/\">median rent is nearly $3,000 a month\u003c/a>, and even higher in coastal regions, where most of California’s unhoused people reside. Experts expect the Biden administration to scrutinize the plan to use health care money to pay rent, and also question its potential effectiveness in light of the state’s \u003ca href=\"https://calmatters.org/housing/2022/10/newsom-california-housing-crisis/\">housing crisis\u003c/a>.\u003c/p>\n\u003cp>“Part of the question is whether this is really Medicaid’s job,” said \u003ca href=\"https://counciloncj.org/vikki-wachino/\">Vikki Wachino\u003c/a>, who served as national Medicaid director in the Obama administration. “But there is a recognition that social factors like inadequate housing are driving health outcomes, and I think the federal government is open to developing approaches to try and address that.”\u003c/p>\n\u003cp>Bruce Alexander, spokesperson for the Centers for Medicare and Medicaid Services, declined to say whether the federal government would approve California’s request. Yet, Biden’s Medicaid officials have approved similar experimental programs in \u003ca href=\"https://www.oregon.gov/oha/HSD/Medicaid-Policy/Pages/Changes.aspx\">Oregon\u003c/a> and \u003ca href=\"https://www.hhs.gov/about/news/2022/10/14/hhs-approves-arizonas-medicaid-interventions-target-health-related-social-needs.html\">Arizona\u003c/a>, and California is modeling its program after them.[aside label=\"Related Stories\" postID=\"news_11934623,news_11932895,news_11927968\"]\u003ca href=\"https://www.ppic.org/blog/homeless-populations-are-rising-around-california/#:~:text=As%20of%202022%2C%2030%25%20of,of%20the%20nation's%20homeless%20population\">California is home to an estimated 30% of unhoused people in the U.S.\u003c/a>, despite representing just 12% of the country’s overall population. And Newsom has acknowledged that the numbers are likely far greater than official homelessness tallies show. Top health officials say that, to contain soaring safety-net spending and to help unhoused people get healthy, Medi-Cal has no choice but to combine social services with housing.\u003c/p>\n\u003cp>Statewide, 5% of Medi-Cal patients account for a staggering 44% of the program’s spending, according to state data. And many of the costliest patients lack stable housing: Nearly half of patients experiencing homelessness visited the emergency room four times or more in 2019 and were more likely than other adults with lower incomes to be admitted to the hospital, and a large majority of visits were covered by Medi-Cal, \u003ca href=\"https://www.ppic.org/publication/how-hospital-discharge-data-can-inform-state-homelessness-policy/\">according to the Public Policy Institute of California\u003c/a>.\u003c/p>\n\u003cp>“What we have today doesn’t work,” said \u003ca href=\"https://www.chhs.ca.gov/about/#secretary\">Dr. Mark Ghaly\u003c/a>, secretary of the California Health and Human Services Agency, explaining his argument that housing is a critical component of health care. “Why do we have to wait so long for people to be so sick?”\u003c/p>\n\u003cp>The federal government has already approved \u003ca href=\"https://khn.org/news/article/california-medicaid-makeover-newsom-california-medi-cal-homeless-public-funds/\">a massive social experiment in California\u003c/a>, known as \u003ca href=\"https://www.dhcs.ca.gov/calaim\">CalAIM\u003c/a>, which is transforming Medi-Cal. Over five years, the initiative is expected to pour $12 billion into new Medi-Cal services delivered outside of traditional health care. In communities across the state, it is already funding services for some patients with lower income, including paying rental security deposits for unhoused people and those facing eviction; \u003ca href=\"https://khn.org/news/article/california-medicaid-medically-tailored-meal-delivery-experiment/\">delivering prepared healthy meals\u003c/a> for people with diabetes; and helping formerly incarcerated people find jobs.\u003c/p>\n\u003cp>The transitional rent program would add another service to \u003ca href=\"https://www.dhcs.ca.gov/Documents/MCQMD/Community-Supports-Elections-by-MCP-and-County.pdf\">those already available (PDF)\u003c/a>, though \u003ca href=\"https://khn.org/news/article/california-governor-newsom-pricey-medicaid-reforms-leave-most-patients-behind/\">only a sliver of the 15.4 million Medi-Cal enrollees\u003c/a> actually receive those new and expensive social services.\u003c/p>\n\u003cp>Rent payments could begin as soon as 2025 and cost roughly $117 million per year once fully implemented. And while state officials say anyone who is homeless or at risk of becoming homeless would be eligible, not everyone who qualifies will receive new services due to capacity limits. Among those who stand to benefit are nearly 11,000 people already enrolled in \u003ca href=\"https://www.dhcs.ca.gov/CalAIM/Documents/CalAIM-HHI-a11y.pdf\">Medi-Cal housing services (PDF)\u003c/a>.\u003c/p>\n\u003cp>“The ongoing conversation is how do we convince the federal government that housing is a health care issue,” said \u003ca href=\"https://www.sellersdorsey.com/team-member/cantwell-mari/\">Mari Cantwell\u003c/a>, who served as Medi-Cal director from 2015 to 2020. “You have to convince them that you’re going to save money because you’re not going to have as many people showing up at the emergency room and in long-term hospitalizations.”\u003c/p>\n\u003cp>Health care experiments in California and around the country that funded housing supports have demonstrated early success in reducing costs and making people healthier. But while some programs paid for housing security deposits or participants’ first month of rent, none directly covered rent for an extended period.[pullquote align=\"right\" size=\"medium\" citation=\"Vikki Wachino, former national director, Medicaid\"]'Part of the question is whether this is really Medicaid’s job. But there is a recognition that social factors like inadequate housing are driving health outcomes, and I think the federal government is open to developing approaches to try and address that.'[/pullquote]“Without that foundational support, we are playing in the margins,” Newsom said.\u003c/p>\n\u003cp>State health officials argue that paying for six months of rent will be even more successful at reducing health care costs and improving enrollees’ health, but experts say that, to work, the initiative must have strict accountability and be bundled with an array of social services.\u003c/p>\n\u003cp>In a precursor to the state’s current initiative, California experimented with a mix of housing assistance programs and social services through its “\u003ca href=\"https://apnews.com/article/california-health-8e353e5539ce36c9068a78f6ee7baeb7\">Whole Person Care\u003c/a>” pilot program. \u003ca href=\"https://healthpolicy.ucla.edu/about/staff/pages/detail.aspx?StaffID=94\">Nadereh Pourat\u003c/a>, of the UCLA Center for Health Policy Research, \u003ca href=\"https://healthpolicy.ucla.edu/publications/search/pages/detail.aspx?PubID=2385\">evaluated the program\u003c/a> for the state concluding that local trials reduced emergency visits and hospitalizations, saving an average of $383 per Medi-Cal beneficiary per year — a meager amount compared with the program’s cost.\u003c/p>\n\u003cp>Over five years, the state spent \u003ca href=\"https://healthpolicy.ucla.edu/publications/Documents/PDF/2023/Final-Evaluation-of-CA-Whole-Person-Care-Report.pdf#page=31\">$3.6 billion (PDF)\u003c/a> serving about 250,000 patients enrolled in \u003ca href=\"https://www.dhcs.ca.gov/services/Pages/WholePersonCarePilots.aspx\">local experiments\u003c/a>, Pourat said.\u003c/p>\n\u003cp>And \u003ca href=\"https://pubmed.ncbi.nlm.nih.gov/32976633/\">a randomized control trial\u003c/a> in Santa Clara County that provided supportive housing for unhoused people showed reductions in psychiatric emergency room visits and improvements in care. “Lives stabilized and we saw a huge uptick in substance-use care and mental health care, the things that everybody wants people to use to get healthier,” said \u003ca href=\"https://profiles.ucsf.edu/margot.kushel\">Dr. Margot Kushel\u003c/a>, director of the University of California-San Francisco’s Center for Vulnerable Populations at Zuckerberg San Francisco General Hospital and Trauma Center, who worked on the study.\u003c/p>\n\u003cp>But insurers implementing the broader Medi-Cal initiative say they are skeptical that spending health care money on housing will save the system money. And health care experts say that, while six months of rent can be a bridge while people wait for permanent housing, there’s a bigger obstacle: California’s affordable-housing shortage.\u003c/p>\n\u003cp>“We can design incredible Medicaid policies to alleviate homelessness and pay for all the necessary supportive services, but without the adequate housing, frankly, it’s not going to work,” Kushel said.\u003c/p>\n\u003cp>Newsom acknowledges that criticism. “The crisis of homelessness will never be solved without first solving the crisis of housing,” he said last week, arguing California should plow more money into housing for homeless people with severe mental health conditions or addiction disorders.[pullquote align=\"right\" size=\"medium\" citation=\"Dr. Margot Kushel, UCSF Center for Vulnerable Populations director, ZSFGH\"]'We can design incredible Medicaid policies to alleviate homelessness and pay for all the necessary supportive services, but without the adequate housing, frankly, it's not going to work.'[/pullquote]He will ask the legislature to put before voters a \u003ca href=\"https://www.latimes.com/california/story/2023-03-19/newsom-mental-health-housing-bond-measure-services-counties-substance-use-treatment\">2024 ballot initiative\u003c/a> that would infuse California’s mental health system with at least 6,000 new treatment beds and supportive housing units for people struggling with mental health and addiction disorders, \u003ca href=\"https://capitolweekly.net/newsom-takes-another-swing-at-getting-mentally-ill-homeless-off-the-streets/\">many of whom are experiencing homelessness\u003c/a>. The proposed bond measure would generate from $3 billion to $5 billion for psychiatric housing and treatment villages aimed at serving more than 10,000 additional people a year. The initiative also would ask voters to set aside at least $1 billion a year for supportive housing from an \u003ca href=\"https://www.dhcs.ca.gov/services/MH/Pages/MH_Prop63.aspx\">existing tax on California millionaires\u003c/a> that funds local mental health programs.\u003c/p>\n\u003cp>“People who are struggling with these issues, especially those who are on the streets or in other vulnerable conditions, will have more resources to get the help they need,” Newsom said.\u003c/p>\n\u003cp>For transitional rent, six months of payments would be available for select high-need residents enrolled in Medi-Cal, particularly those who are unhoused or at risk of becoming unhoused — and those transitioning from more costly institutions such as mental health crisis centers, jails and prisons, and foster care. Medi-Cal patients at risk of inpatient hospitalization or who frequent the emergency room would also be eligible.\u003c/p>\n\u003cp>“It’s a pretty big challenge; I’m not going to lie,” said \u003ca href=\"https://conference.healthmanagement.com/jacey-cooper/\">Jacey Cooper\u003c/a>, the Medi-Cal director. “But we know that people experiencing homelessness cycle in and out of emergency rooms, so we have a real role to play in both preventing and ending homelessness.”\u003c/p>\n\u003cp>Public health experts say the \u003ca href=\"https://khn.org/news/article/california-homeless-crisis-governor-gavin-newsom-political-future/\">problem will continue to explode\u003c/a> without creative thinking about how to fund housing in health care, but they warn the state must be wary of potential abuses of the program.\u003c/p>\n\u003cp>“It has to be designed carefully because, unfortunately, there are always people looking to game the system,” said \u003ca href=\"https://www.calendow.org/leadership/\">Dr. Tony Iton\u003c/a>, a public health expert who is now a senior vice president at the California Endowment. “Decisions must be made by clinicians — not housing organizations just looking for another source of revenue.”\u003c/p>\n\u003cp>For Stephen Morton, who lives in the Orange County community of Laguna Woods, the journey from homelessness into permanent housing illustrates the amount of public spending it can take for the effort to pay off.\u003c/p>\n\u003cfigure id=\"attachment_11944656\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg decoding=\"async\" loading=\"lazy\" class=\"size-medium wp-image-11944656\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/03/stephen_morton-6-resized-copy-800x533.jpg\" alt=\"A white middle aged man combs his hair in front of a mirror in a bedroom with a lamp, a speaker, a bottle of eau de toilette anfd a box with a card on a dresser in front of the mirror.\" width=\"800\" height=\"533\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2023/03/stephen_morton-6-resized-copy-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/10/2023/03/stephen_morton-6-resized-copy-1020x680.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/10/2023/03/stephen_morton-6-resized-copy-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/10/2023/03/stephen_morton-6-resized-copy-1536x1024.jpg 1536w, https://ww2.kqed.org/app/uploads/sites/10/2023/03/stephen_morton-6-resized-copy-1920x1280.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/10/2023/03/stephen_morton-6-resized-copy.jpg 2048w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Stephen Morton, who lived in shelters and sometimes in his car for almost 2 years before finding permanent housing, receives weekly deliveries of medically tailored meals as part of a Medi-Cal initiative. Since getting his apartment, Morton says he's been able to stop taking one diabetes medication and lose weight. \u003ccite>(Heidi de Marco/KHN)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Morton, 60, bounced between shelters and his car for nearly two years and racked up extraordinary Medi-Cal costs due to prolonged hospitalizations and repeated emergency room trips to treat chronic heart disease, asthma and diabetes.\u003c/p>\n\u003cp>Medi-Cal covered Morton’s open-heart surgery and hospital stays, which lasted weeks. He landed temporary housing through a state-sponsored program called \u003ca href=\"https://www.cdss.ca.gov/inforesources/cdss-programs/housing-programs/project-roomkey\">Project Roomkey\u003c/a> before getting permanent housing through a federal low-income housing voucher — an ongoing benefit that covers all but $50 of his rent.\u003c/p>\n\u003cp>Since getting his apartment, Morton said, he’s been able to stop taking one diabetes medication and lose weight. He attributes improvements in his blood sugar levels to his housing and the healthy, home-delivered meals he receives via Medi-Cal.\u003c/p>\n\u003cp>“It’s usually scrambled eggs for breakfast and the fish menu for dinner. I’m shocked it’s so good,” Morton said. “Now I have a microwave and I’m indoors. I’m so grateful and so much healthier.”\u003c/p>\n\u003cp>\u003cem>California Healthline is a service of the California Health Care Foundation produced by Kaiser Health News.\u003c/em>\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n","blocks":[],"excerpt":"California's bold new 'transitional rent' plan would save costs from frequent ER visits and lengthy hospital stays for Medi-Cal patients, but Newsom needs to convince Biden, saying, 'We cannot do this alone,' and lack of affordable housing across the state remains a concern.","status":"publish","parent":0,"modified":1680038048,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":34,"wordCount":2066},"headData":{"title":"Gov. Newsom's Prescription Housing Plan Would Cover 6 Months' Rent Through Medi-Cal | KQED","description":"California's bold new 'transitional rent' plan would save costs from frequent ER visits and lengthy hospital stays for Medi-Cal patients, but Newsom needs to convince Biden, saying, 'We cannot do this alone,' and lack of affordable housing across the state remains a concern.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":""},"nprByline":"\u003ca href=\"https://californiahealthline.org/news/author/angela-hart/\">Angela Hart\u003c/a>","excludeFromSiteSearch":"Include","showOnAuthorArchivePages":"No","articleAge":"0","path":"/news/11944613/gov-newsoms-prescription-housing-plan-would-cover-6-months-rent-through-medi-cal","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Gov. Gavin Newsom, whose administration is struggling to contain a worsening homelessness crisis despite \u003ca href=\"https://khn.org/news/article/california-homeless-crisis-governor-gavin-newsom-political-future/\">record spending\u003c/a>, is trying something bold: tapping federal health care funding to cover rent for unhoused people and those at risk of losing their housing.\u003c/p>\n\u003cp>States are barred from using federal Medicaid dollars to pay directly for rent, but California’s governor is asking the administration of President Joe Biden, a fellow Democrat, to authorize a new program called “\u003ca href=\"https://ebudget.ca.gov/2023-24/pdf/BudgetSummary/HealthandHumanServices.pdf\">transitional rent (PDF)\u003c/a>,” which would provide up to six months of rent or temporary housing for\u003ca href=\"https://khn.org/news/article/californias-massive-medicaid-program-works-for-some-but-fails-many-others/\"> enrollees with \u003c/a>\u003ca href=\"https://khn.org/news/article/californias-massive-medicaid-program-works-for-some-but-fails-many-others/\">lower incomes\u003c/a> who rely on the state’s health care safety net — a new initiative to fight and prevent homelessness.\u003c/p>\n\u003cp>“I’ve been talking to the president. We cannot do this alone,” Newsom told California Healthline.\u003c/p>\n\u003cp>The governor is pushing California’s version of Medicaid, called Medi-Cal, to fund experimental housing subsidies for people experiencing homelessness, betting that it’s cheaper for taxpayers to cover rent than to allow people to fall into crisis or costly institutional care in hospitals, nursing homes and jails. Early in his tenure, \u003ca href=\"https://www.gov.ca.gov/2020/02/19/governor-newsom-delivers-state-of-the-state-address-on-homelessness/\">Newsom proclaimed\u003c/a> that “doctors should be able to write prescriptions for housing the same way they do for insulin or antibiotics.”\u003c/p>\n\u003cp>But it’s a risky endeavor in a high-cost state where \u003ca href=\"https://www.zillow.com/rental-manager/market-trends/ca/\">median rent is nearly $3,000 a month\u003c/a>, and even higher in coastal regions, where most of California’s unhoused people reside. Experts expect the Biden administration to scrutinize the plan to use health care money to pay rent, and also question its potential effectiveness in light of the state’s \u003ca href=\"https://calmatters.org/housing/2022/10/newsom-california-housing-crisis/\">housing crisis\u003c/a>.\u003c/p>\n\u003cp>“Part of the question is whether this is really Medicaid’s job,” said \u003ca href=\"https://counciloncj.org/vikki-wachino/\">Vikki Wachino\u003c/a>, who served as national Medicaid director in the Obama administration. “But there is a recognition that social factors like inadequate housing are driving health outcomes, and I think the federal government is open to developing approaches to try and address that.”\u003c/p>\n\u003cp>Bruce Alexander, spokesperson for the Centers for Medicare and Medicaid Services, declined to say whether the federal government would approve California’s request. Yet, Biden’s Medicaid officials have approved similar experimental programs in \u003ca href=\"https://www.oregon.gov/oha/HSD/Medicaid-Policy/Pages/Changes.aspx\">Oregon\u003c/a> and \u003ca href=\"https://www.hhs.gov/about/news/2022/10/14/hhs-approves-arizonas-medicaid-interventions-target-health-related-social-needs.html\">Arizona\u003c/a>, and California is modeling its program after them.\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"aside","attributes":{"named":{"label":"Related Stories ","postid":"news_11934623,news_11932895,news_11927968"},"numeric":[]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003ca href=\"https://www.ppic.org/blog/homeless-populations-are-rising-around-california/#:~:text=As%20of%202022%2C%2030%25%20of,of%20the%20nation's%20homeless%20population\">California is home to an estimated 30% of unhoused people in the U.S.\u003c/a>, despite representing just 12% of the country’s overall population. And Newsom has acknowledged that the numbers are likely far greater than official homelessness tallies show. Top health officials say that, to contain soaring safety-net spending and to help unhoused people get healthy, Medi-Cal has no choice but to combine social services with housing.\u003c/p>\n\u003cp>Statewide, 5% of Medi-Cal patients account for a staggering 44% of the program’s spending, according to state data. And many of the costliest patients lack stable housing: Nearly half of patients experiencing homelessness visited the emergency room four times or more in 2019 and were more likely than other adults with lower incomes to be admitted to the hospital, and a large majority of visits were covered by Medi-Cal, \u003ca href=\"https://www.ppic.org/publication/how-hospital-discharge-data-can-inform-state-homelessness-policy/\">according to the Public Policy Institute of California\u003c/a>.\u003c/p>\n\u003cp>“What we have today doesn’t work,” said \u003ca href=\"https://www.chhs.ca.gov/about/#secretary\">Dr. Mark Ghaly\u003c/a>, secretary of the California Health and Human Services Agency, explaining his argument that housing is a critical component of health care. “Why do we have to wait so long for people to be so sick?”\u003c/p>\n\u003cp>The federal government has already approved \u003ca href=\"https://khn.org/news/article/california-medicaid-makeover-newsom-california-medi-cal-homeless-public-funds/\">a massive social experiment in California\u003c/a>, known as \u003ca href=\"https://www.dhcs.ca.gov/calaim\">CalAIM\u003c/a>, which is transforming Medi-Cal. Over five years, the initiative is expected to pour $12 billion into new Medi-Cal services delivered outside of traditional health care. In communities across the state, it is already funding services for some patients with lower income, including paying rental security deposits for unhoused people and those facing eviction; \u003ca href=\"https://khn.org/news/article/california-medicaid-medically-tailored-meal-delivery-experiment/\">delivering prepared healthy meals\u003c/a> for people with diabetes; and helping formerly incarcerated people find jobs.\u003c/p>\n\u003cp>The transitional rent program would add another service to \u003ca href=\"https://www.dhcs.ca.gov/Documents/MCQMD/Community-Supports-Elections-by-MCP-and-County.pdf\">those already available (PDF)\u003c/a>, though \u003ca href=\"https://khn.org/news/article/california-governor-newsom-pricey-medicaid-reforms-leave-most-patients-behind/\">only a sliver of the 15.4 million Medi-Cal enrollees\u003c/a> actually receive those new and expensive social services.\u003c/p>\n\u003cp>Rent payments could begin as soon as 2025 and cost roughly $117 million per year once fully implemented. And while state officials say anyone who is homeless or at risk of becoming homeless would be eligible, not everyone who qualifies will receive new services due to capacity limits. Among those who stand to benefit are nearly 11,000 people already enrolled in \u003ca href=\"https://www.dhcs.ca.gov/CalAIM/Documents/CalAIM-HHI-a11y.pdf\">Medi-Cal housing services (PDF)\u003c/a>.\u003c/p>\n\u003cp>“The ongoing conversation is how do we convince the federal government that housing is a health care issue,” said \u003ca href=\"https://www.sellersdorsey.com/team-member/cantwell-mari/\">Mari Cantwell\u003c/a>, who served as Medi-Cal director from 2015 to 2020. “You have to convince them that you’re going to save money because you’re not going to have as many people showing up at the emergency room and in long-term hospitalizations.”\u003c/p>\n\u003cp>Health care experiments in California and around the country that funded housing supports have demonstrated early success in reducing costs and making people healthier. But while some programs paid for housing security deposits or participants’ first month of rent, none directly covered rent for an extended period.\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"'Part of the question is whether this is really Medicaid’s job. But there is a recognition that social factors like inadequate housing are driving health outcomes, and I think the federal government is open to developing approaches to try and address that.'","name":"pullquote","attributes":{"named":{"align":"right","size":"medium","citation":"Vikki Wachino, former national director, Medicaid","label":""},"numeric":[]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>“Without that foundational support, we are playing in the margins,” Newsom said.\u003c/p>\n\u003cp>State health officials argue that paying for six months of rent will be even more successful at reducing health care costs and improving enrollees’ health, but experts say that, to work, the initiative must have strict accountability and be bundled with an array of social services.\u003c/p>\n\u003cp>In a precursor to the state’s current initiative, California experimented with a mix of housing assistance programs and social services through its “\u003ca href=\"https://apnews.com/article/california-health-8e353e5539ce36c9068a78f6ee7baeb7\">Whole Person Care\u003c/a>” pilot program. \u003ca href=\"https://healthpolicy.ucla.edu/about/staff/pages/detail.aspx?StaffID=94\">Nadereh Pourat\u003c/a>, of the UCLA Center for Health Policy Research, \u003ca href=\"https://healthpolicy.ucla.edu/publications/search/pages/detail.aspx?PubID=2385\">evaluated the program\u003c/a> for the state concluding that local trials reduced emergency visits and hospitalizations, saving an average of $383 per Medi-Cal beneficiary per year — a meager amount compared with the program’s cost.\u003c/p>\n\u003cp>Over five years, the state spent \u003ca href=\"https://healthpolicy.ucla.edu/publications/Documents/PDF/2023/Final-Evaluation-of-CA-Whole-Person-Care-Report.pdf#page=31\">$3.6 billion (PDF)\u003c/a> serving about 250,000 patients enrolled in \u003ca href=\"https://www.dhcs.ca.gov/services/Pages/WholePersonCarePilots.aspx\">local experiments\u003c/a>, Pourat said.\u003c/p>\n\u003cp>And \u003ca href=\"https://pubmed.ncbi.nlm.nih.gov/32976633/\">a randomized control trial\u003c/a> in Santa Clara County that provided supportive housing for unhoused people showed reductions in psychiatric emergency room visits and improvements in care. “Lives stabilized and we saw a huge uptick in substance-use care and mental health care, the things that everybody wants people to use to get healthier,” said \u003ca href=\"https://profiles.ucsf.edu/margot.kushel\">Dr. Margot Kushel\u003c/a>, director of the University of California-San Francisco’s Center for Vulnerable Populations at Zuckerberg San Francisco General Hospital and Trauma Center, who worked on the study.\u003c/p>\n\u003cp>But insurers implementing the broader Medi-Cal initiative say they are skeptical that spending health care money on housing will save the system money. And health care experts say that, while six months of rent can be a bridge while people wait for permanent housing, there’s a bigger obstacle: California’s affordable-housing shortage.\u003c/p>\n\u003cp>“We can design incredible Medicaid policies to alleviate homelessness and pay for all the necessary supportive services, but without the adequate housing, frankly, it’s not going to work,” Kushel said.\u003c/p>\n\u003cp>Newsom acknowledges that criticism. “The crisis of homelessness will never be solved without first solving the crisis of housing,” he said last week, arguing California should plow more money into housing for homeless people with severe mental health conditions or addiction disorders.\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"'We can design incredible Medicaid policies to alleviate homelessness and pay for all the necessary supportive services, but without the adequate housing, frankly, it's not going to work.'","name":"pullquote","attributes":{"named":{"align":"right","size":"medium","citation":"Dr. Margot Kushel, UCSF Center for Vulnerable Populations director, ZSFGH","label":""},"numeric":[]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>He will ask the legislature to put before voters a \u003ca href=\"https://www.latimes.com/california/story/2023-03-19/newsom-mental-health-housing-bond-measure-services-counties-substance-use-treatment\">2024 ballot initiative\u003c/a> that would infuse California’s mental health system with at least 6,000 new treatment beds and supportive housing units for people struggling with mental health and addiction disorders, \u003ca href=\"https://capitolweekly.net/newsom-takes-another-swing-at-getting-mentally-ill-homeless-off-the-streets/\">many of whom are experiencing homelessness\u003c/a>. The proposed bond measure would generate from $3 billion to $5 billion for psychiatric housing and treatment villages aimed at serving more than 10,000 additional people a year. The initiative also would ask voters to set aside at least $1 billion a year for supportive housing from an \u003ca href=\"https://www.dhcs.ca.gov/services/MH/Pages/MH_Prop63.aspx\">existing tax on California millionaires\u003c/a> that funds local mental health programs.\u003c/p>\n\u003cp>“People who are struggling with these issues, especially those who are on the streets or in other vulnerable conditions, will have more resources to get the help they need,” Newsom said.\u003c/p>\n\u003cp>For transitional rent, six months of payments would be available for select high-need residents enrolled in Medi-Cal, particularly those who are unhoused or at risk of becoming unhoused — and those transitioning from more costly institutions such as mental health crisis centers, jails and prisons, and foster care. Medi-Cal patients at risk of inpatient hospitalization or who frequent the emergency room would also be eligible.\u003c/p>\n\u003cp>“It’s a pretty big challenge; I’m not going to lie,” said \u003ca href=\"https://conference.healthmanagement.com/jacey-cooper/\">Jacey Cooper\u003c/a>, the Medi-Cal director. “But we know that people experiencing homelessness cycle in and out of emergency rooms, so we have a real role to play in both preventing and ending homelessness.”\u003c/p>\n\u003cp>Public health experts say the \u003ca href=\"https://khn.org/news/article/california-homeless-crisis-governor-gavin-newsom-political-future/\">problem will continue to explode\u003c/a> without creative thinking about how to fund housing in health care, but they warn the state must be wary of potential abuses of the program.\u003c/p>\n\u003cp>“It has to be designed carefully because, unfortunately, there are always people looking to game the system,” said \u003ca href=\"https://www.calendow.org/leadership/\">Dr. Tony Iton\u003c/a>, a public health expert who is now a senior vice president at the California Endowment. “Decisions must be made by clinicians — not housing organizations just looking for another source of revenue.”\u003c/p>\n\u003cp>For Stephen Morton, who lives in the Orange County community of Laguna Woods, the journey from homelessness into permanent housing illustrates the amount of public spending it can take for the effort to pay off.\u003c/p>\n\u003cfigure id=\"attachment_11944656\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg decoding=\"async\" loading=\"lazy\" class=\"size-medium wp-image-11944656\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/03/stephen_morton-6-resized-copy-800x533.jpg\" alt=\"A white middle aged man combs his hair in front of a mirror in a bedroom with a lamp, a speaker, a bottle of eau de toilette anfd a box with a card on a dresser in front of the mirror.\" width=\"800\" height=\"533\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2023/03/stephen_morton-6-resized-copy-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/10/2023/03/stephen_morton-6-resized-copy-1020x680.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/10/2023/03/stephen_morton-6-resized-copy-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/10/2023/03/stephen_morton-6-resized-copy-1536x1024.jpg 1536w, https://ww2.kqed.org/app/uploads/sites/10/2023/03/stephen_morton-6-resized-copy-1920x1280.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/10/2023/03/stephen_morton-6-resized-copy.jpg 2048w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Stephen Morton, who lived in shelters and sometimes in his car for almost 2 years before finding permanent housing, receives weekly deliveries of medically tailored meals as part of a Medi-Cal initiative. Since getting his apartment, Morton says he's been able to stop taking one diabetes medication and lose weight. \u003ccite>(Heidi de Marco/KHN)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Morton, 60, bounced between shelters and his car for nearly two years and racked up extraordinary Medi-Cal costs due to prolonged hospitalizations and repeated emergency room trips to treat chronic heart disease, asthma and diabetes.\u003c/p>\n\u003cp>Medi-Cal covered Morton’s open-heart surgery and hospital stays, which lasted weeks. He landed temporary housing through a state-sponsored program called \u003ca href=\"https://www.cdss.ca.gov/inforesources/cdss-programs/housing-programs/project-roomkey\">Project Roomkey\u003c/a> before getting permanent housing through a federal low-income housing voucher — an ongoing benefit that covers all but $50 of his rent.\u003c/p>\n\u003cp>Since getting his apartment, Morton said, he’s been able to stop taking one diabetes medication and lose weight. He attributes improvements in his blood sugar levels to his housing and the healthy, home-delivered meals he receives via Medi-Cal.\u003c/p>\n\u003cp>“It’s usually scrambled eggs for breakfast and the fish menu for dinner. I’m shocked it’s so good,” Morton said. “Now I have a microwave and I’m indoors. I’m so grateful and so much healthier.”\u003c/p>\n\u003cp>\u003cem>California Healthline is a service of the California Health Care Foundation produced by Kaiser Health News.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/news/11944613/gov-newsoms-prescription-housing-plan-would-cover-6-months-rent-through-medi-cal","authors":["byline_news_11944613"],"categories":["news_31795","news_457","news_6266","news_8"],"tags":["news_25015","news_1775","news_2605","news_20666","news_32576"],"affiliates":["news_20286"],"featImg":"news_11944665","label":"news_20286"},"news_11944543":{"type":"posts","id":"news_11944543","meta":{"index":"posts_1591205157","site":"news","id":"11944543","score":null,"sort":[1679687668000]},"guestAuthors":[],"slug":"on-medi-cal-eligibility-changes-starting-in-april-could-mean-you-lose-coverage-heres-what-to-do","title":"On Medi-Cal? Eligibility Changes Starting in April Could Mean You Lose Coverage. Here's What to Do","publishDate":1679687668,"format":"image","headTitle":"On Medi-Cal? Eligibility Changes Starting in April Could Mean You Lose Coverage. Here’s What to Do | KQED","labelTerm":{"site":"news"},"content":"\u003cp>Starting April 1, Californians who depend on \u003ca href=\"https://www.dhcs.ca.gov/Pages/myMedi-Cal.aspx\">Medi-Cal\u003c/a> — the state’s Medicaid health care program — for their health care expenses will need to once again \u003ca href=\"https://www.dhcs.ca.gov/Pages/Keep-Your-Medi-Cal.aspx\">go through a redetermination process to renew their eligibility and keep their Medi-Cal coverage\u003c/a>.\u003c/p>\n\u003cp>Thanks to \u003ca href=\"https://www.hhs.gov/about/news/2023/02/09/fact-sheet-covid-19-public-health-emergency-transition-roadmap.html\">the federal COVID Public Health Emergency (PHE)\u003c/a> declared in 2020, Medicaid programs around the nation like Medi-Cal have been able to waive annual eligibility requirements. This means that for the past three years, Medicaid beneficiaries had their health care costs covered without having to go through an annual renewal process, which could have found them no longer eligible to receive Medicaid.\u003c/p>\n\u003cp>But at the end of last year, Congress approved the Consolidated Appropriations Act — putting \u003ca href=\"https://www.hhs.gov/about/news/2023/02/09/fact-sheet-covid-19-public-health-emergency-transition-roadmap.html\">an end date of March 31 on automatic Medicaid renewal\u003c/a>.\u003c/p>\n\u003cp>\u003cstrong>Jump to:\u003c/strong>\u003c/p>\n\u003cul>\n\u003cli>\u003cstrong>\u003ca href=\"#keepmedicaid\">What do I need to do to keep my Medi-Cal coverage?\u003c/a>\u003c/strong>\u003c/li>\n\u003cli>\u003cstrong>\u003ca href=\"#helpmedicaid\">Find my Bay Area county’s Medi-Cal office\u003c/a>\u003c/strong>\u003c/li>\n\u003c/ul>\n\u003ch2>Who will be affected by these Medi-Cal changes?\u003c/h2>\n\u003cp>This change will affect the millions of people nationwide who depend on Medicaid to cover essential care, prescriptions and other health care services, including the 12 million people enrolled in Medi-Cal within California.\u003c/p>\n\u003cp>The Urban Institute, a public policy think tank, released a study at the end of 2022 that estimates that \u003ca href=\"https://www.urban.org/research/publication/impact-covid-19-public-health-emergency-expiration-all-types-health-coverage\">18 million people nationwide may lose their Medicaid\u003c/a> coverage during a 14-month period following the end of the PHE — either because they are found to no longer qualify for Medi-Cal, or because they fail to renew on time. \u003ca href=\"https://www.dhcs.ca.gov/Documents/PHE-UOP/Medi-Cal-COVID-19-PHE-Unwinding-Plan.pdf\">In California, that number could be as high as 3 million.\u003c/a>\u003c/p>\n\u003cul>\n\u003cli>\u003cstrong>\u003ca href=\"#tellus\">Tell us: What else do you need information about right now?\u003c/a>\u003c/strong>\u003c/li>\n\u003c/ul>\n\u003cp>Disability rights advocates also worry that the renewal process could leave people without health coverage. “Administrative and procedural barriers can also lead to someone being dis-enrolled, with \u003ca href=\"https://www.teenvogue.com/story/medicaid-coverage-covid\">low-income people and people of color disproportionately at higher risk due to structural inequities\u003c/a>,” wrote San Francisco disability rights activist Alice Wong in a recent column for \u003cem>Teen Vogue.\u003c/em>\u003c/p>\n\u003cp>Individuals who received Medi-Cal benefits before the pandemic began may remember what it’s like to renew eligibility: Your county’s health and human services agency sends to your mailbox a thick packet full of forms to fill out and verify your residency, income, health information and other personal details.\u003c/p>\n\u003cp>But regardless of whether you have been on Medi-Cal for decades, or joined far more recently during the pandemic, \u003ca href=\"https://www.dhcs.ca.gov/Pages/Keep-Your-Medi-Cal.aspx\">the redetermination process will be required for all Medi-Cal beneficiaries\u003c/a>. This means that every single person on Medi-Cal needs to be aware of the coming changes starting in April, to make sure they keep health care coverage in some form.\u003c/p>\n\u003cp>Keep reading for what you need to know.\u003c/p>\n\u003cfigure id=\"attachment_11944676\" class=\"wp-caption alignnone\" style=\"max-width: 1920px\">\u003cimg decoding=\"async\" loading=\"lazy\" class=\"size-full wp-image-11944676\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/03/pexels-rodnae-productions-7821577.jpg\" alt=\"A photograph shot from behind of two people, whose faces we can't see, operating a laptop to fill out a form.\" width=\"1920\" height=\"1280\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2023/03/pexels-rodnae-productions-7821577.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/10/2023/03/pexels-rodnae-productions-7821577-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/10/2023/03/pexels-rodnae-productions-7821577-1020x680.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/10/2023/03/pexels-rodnae-productions-7821577-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/10/2023/03/pexels-rodnae-productions-7821577-1536x1024.jpg 1536w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Changes are coming to Medi-Cal eligibility, and you’ll have to act to keep coverage. \u003ccite>(RODNAE Productions/Pexels)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003ch2>\u003ca id=\"keepmedicaid\">\u003c/a>On Medi-Cal? Here’s what to expect starting April 1\u003c/h2>\n\u003cp>Nobody will be automatically dropped from their Medi-Cal coverage on April 1, says María Reyes, community health education manager for La Clínica de la Raza, which provides health services to lower-income communities in Alameda, Contra Costa and Solano counties.\u003c/p>\n\u003cp>Instead, that date marks the start of the process to reenroll people on Medi-Cal.\u003c/p>\n\u003cp>Once the Medi-Cal renewal waiver ends on March 31, there will be two ways people can renew their benefits: through the mail or \u003ca href=\"https://www.dhcs.ca.gov/Pages/Keep-Your-Medi-Cal.aspx\">online at the Medi-Cal website\u003c/a>. But it’s important to remember that the deadline to renew will be different for everyone, says Reyes.\u003c/p>\n\u003cp>The deadline to renew your personal coverage, she says, is based on your Medi-Cal “anniversary”:\u003c/p>\n\u003cul>\n\u003cli>If you had Medi-Cal \u003cstrong>before 2020\u003c/strong>, your anniversary is the date when you last renewed your coverage before the pandemic, but:\u003c/li>\n\u003cli>If you enrolled \u003cstrong>after 2020\u003c/strong> and haven’t gone through the renewal process yet, your anniversary falls on the date you first applied.\u003c/li>\n\u003c/ul>\n\u003cp>Reyes recommends that you confirm the exact date of your coverage anniversary — because you should receive a renewal packet in the mail ahead of this date.\u003c/p>\n\u003cp>\u003cstrong>Option 1: Renew your Medi-Cal coverage by mail\u003c/strong>\u003c/p>\n\u003cp>“As people meet their anniversary date, they’ll be getting these packets,” she says, adding that the packets will include a letter with information specific to your coverage. “This letter will let you know you have X amount of time, from the time you receive the letter, to submit your renewal packet and the documents they are requesting from you.”\u003c/p>\n\u003cp>\u003ca href=\"https://calmatters.org/health/2023/03/medi-cal-eligibility-2/\">These packets will be going out in phases monthly up through June 2024\u003c/a>, and will include \u003ca href=\"https://www.dhcs.ca.gov/formsandpubs/forms/Forms/mc210rv-eng.pdf\">an annual redetermination form (PDF)\u003c/a> which asks for information about a beneficiary’s income, living situation and disability status, among other factors. You may be asked to submit additional documents depending on your circumstances. You should fill it out and return it as soon as possible, if you don’t plan on renewing your Medi-Cal online (see Option 2).\u003c/p>\n\u003cp>“If, for some reason, your county office doesn’t get the packet by the deadline, they’ll send another reminder letter letting you know they haven’t received your documents,” Reyes said, adding that there may be a \u003cem>third\u003c/em> letter in the mail if a beneficiary misses the second deadline. There should, she assures, be several opportunities for people to be reminded of this deadline. “It’s not going to be a sudden stop of services,” she said.\u003c/p>\n\u003cp>\u003cstrong>Option 2: Renew your Medi-Cal coverage online\u003c/strong>\u003c/p>\n\u003cp>In some cases, you may be able to renew online. In the Bay Area, counties use either one of two renewal portals:\u003c/p>\n\u003cul>\n\u003cli>If you live in Alameda, San Francisco, San Mateo, Solano and Sonoma counties, visit \u003ca href=\"https://www.mybenefitscalwin.org/#/home\">MyBenefitsCalWin\u003c/a> to renew your Medi-Cal.\u003c/li>\n\u003cli>If you live in Contra Costa, Marin, Napa or Santa Clara counties, visit \u003ca href=\"https://benefitscal.com/\">BenefitsCal\u003c/a> to renew your Medi-Cal.\u003c/li>\n\u003c/ul>\n\u003cp>If you live somewhere else in California, \u003ca href=\"https://www.dhcs.ca.gov/Pages/Keep-Your-Medi-Cal.aspx\">see which website your county uses for your to renew your Medi-Cal\u003c/a>.\u003c/p>\n\u003ch2>What if I am found to no longer be eligible for Medi-Cal?\u003c/h2>\n\u003cp>If you don’t renew your Medi-Cal by the deadline (see Options 1 and 2, in the previous section), or are found to no longer be eligible, you’ll be removed from Medi-Cal coverage. And if that happens, you’ll have other options for subsidized health care coverage — but at a cost.\u003c/p>\n\u003cp>Yingjia Huang, assistant deputy director for health care benefits and eligibility at the Department of Health Care Services, told CalMatters that \u003ca href=\"https://calmatters.org/health/2023/03/medi-cal-eligibility-2/\">if you no longer qualify for Medi-Cal because your income has gone up, you’ll be “automatically” transitioned\u003c/a> into a similar plan through Covered California. “The system automatically will review their eligibility for Covered California, and Covered California will send out the enrollment notice to the member, informing them of their options and to pay the plan premium,” said Huang. There’ll be “no administrative burden on a member,” she stressed.\u003c/p>\n\u003cp>But of course, this may come with a new monthly premium that many folks on Medi-Cal haven’t had to pay before — and might not feel able to when factoring in their other expenses.\u003c/p>\n\u003cp>The state emphasizes that \u003ca href=\"https://www.coveredca.com/marketing-blog/health-insurance-costs-less-thanks-to-the-inflation-reduction-act/\">nearly half of people getting health care through Covered California pay less than $50\u003c/a>, while nearly a quarter of people don’t pay a monthly premium at all.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003ch2>What happens if I don’t get my renewal packet in the mail?\u003c/h2>\n\u003cp>Reyes is keen to reiterate that no one will be automatically dropped from their Medi-Cal coverage on April 1. “Starting on that date, people should be on the lookout for these renewal packages that they will need to complete,” she said.\u003c/p>\n\u003cp>If your coverage anniversary rolls around and you have not received a renewal packet, there may be several possibilities to explain why:\u003c/p>\n\u003cul>\n\u003cli>You may have the wrong date on file for your anniversary, or:\u003c/li>\n\u003cli>Your county may be sending the packet to an old address (more likely \u003ca href=\"https://www.sfhsa.org/services/health/medi-cal/renew-your-medi-cal-coverage\">if you moved during the pandemic\u003c/a>).\u003c/li>\n\u003c/ul>\n\u003cp>In either case, you should confirm your information with your county directly. You can do this online:\u003c/p>\n\u003cul>\n\u003cli>If you live in Alameda, San Francisco, San Mateo, Solano and Sonoma counties, visit \u003ca href=\"https://www.mybenefitscalwin.org/#/home\">MyBenefitsCalWin\u003c/a> to update your Medi-Cal contact information.\u003c/li>\n\u003cli>If you live in Contra Costa, Marin, Napa or Santa Clara counties, visit \u003ca href=\"https://benefitscal.com/\">BenefitsCal\u003c/a> to update your Medi-Cal contact information.\u003c/li>\n\u003c/ul>\n\u003cp>You can also contact the office in your county that manages Medi-Cal enrollment. Find your county in the list below.\u003c/p>\n\u003ch2>\u003ca id=\"helpmedicaid\">\u003c/a>Get direct assistance with Medi-Cal and update your contact details\u003c/h2>\n\u003cp>\u003cstrong>Alameda County\u003c/strong>: \u003ca href=\"https://www.alamedacountysocialservices.org/our-services/Health-and-Food/Medi-Cal/index\">Social Services Agency\u003c/a>, 24100 Amador Street, Hayward; call (888) 999-4772.\u003c/p>\n\u003cp>\u003cstrong>Contra Costa County\u003c/strong>: \u003ca href=\"https://ehsd.org/benefits/medi-cal-and-health-coverage-options/\">Employment and Human Services\u003c/a>, multiple addresses; call (866) 663-3225.\u003c/p>\n\u003cp>\u003cstrong>Marin County\u003c/strong>: \u003ca href=\"https://www.marinhhs.org/medi-cal\">Health and Human Services\u003c/a>, 120 N. Redwood Drive, San Rafael; call (877) 410-8817.\u003c/p>\n\u003cp>\u003cstrong>Napa County\u003c/strong>: \u003ca href=\"https://www.countyofnapa.org/3304/Self-Sufficiency-Services\">Health and Human Services\u003c/a>, 2751 Napa Valley Corporate Drive, Napa; call (707) 253-4511.\u003c/p>\n\u003cp>\u003cstrong>San Francisco\u003c/strong>: \u003ca href=\"https://www.sfhsa.org/services/health/medi-cal/renew-your-medi-cal-coverage\">Human Services Agency\u003c/a>, 1440 Harrison Street, San Francisco; call (415) 558-4700.\u003c/p>\n\u003cp>\u003cstrong>San Mateo County\u003c/strong>: \u003ca href=\"https://www.smcgov.org/hsa/health-coverage\">Human Services\u003c/a>, 400 Harbor Boulevard, Building B, Belmont; call (800) 223-8383.\u003c/p>\n\u003cp>\u003cstrong>Santa Clara County\u003c/strong>: \u003ca href=\"https://socialservices.sccgov.org/health-coverage\">Social Services Agency\u003c/a>, 1867 Senter Road, San José; call (408) 758-3800.\u003c/p>\n\u003cp>\u003cstrong>Solano County\u003c/strong>: \u003ca href=\"https://www.solanocounty.com/depts/hss/ees/medical/default.asp\">Health and Social Services\u003c/a>, multiple addresses; call (707) 784-3900.\u003c/p>\n\u003cp>\u003cstrong>Sonoma County\u003c/strong>: \u003ca href=\"https://sonomacounty.ca.gov/health-and-human-services/human-services/divisions-and-services/economic-assistance/health-care-benefits/medi-cal-and-county-medical-services-program\">Department of Human Services\u003c/a>, 2550 Paulin Drive, Santa Rosa, or 5350 Old Redwood Highway, Suite 100, Petaluma; call (877) 699-6868.\u003c/p>\n\u003ch2>Remember, you don’t have to go through this alone\u003c/h2>\n\u003cp>If you are a parent or caregiver and managing a family all by yourself, working multiple jobs or managing a chronic illness, the Medi-Cal renewal process is another item on a long list of responsibilities you are already juggling. You might also be facing \u003ca href=\"https://www.kqed.org/news/11943420/your-calfresh-benefits-will-drop-in-april-heres-what-you-can-do\">a drop in your CalFresh benefits (SNAP, or food stamps)\u003c/a> at the same time as this Medi-Cal renewal, starting in April.\u003c/p>\n\u003cp>Many organizations across California are helping folks send their renewal packets in on time and keep their coverage. One of them is La Clínica de la Raza, which has set up a service that provides individual assistance to Medi-Cal recipients living in Alameda, Contra Costa or Solano counties while completing the renewal requirements.\u003c/p>\n\u003cp>“We don’t want people to lose coverage, especially because preventative services are important — particularly for those who have chronic conditions,” said Reyes, from La Clínica. “We want to make sure that they’re not at risk of losing coverage, not being able to see their provider, not able to refill their prescriptions. So taking action as soon as possible is important.”\u003c/p>\n\u003cp>If you are on Medi-Cal and live in Alameda, Contra Costa or Solano counties, contact La Clínica de la Raza at (855) 494-4658. Help is available in both English and Spanish.\u003c/p>\n\u003cp>Reyes adds that your county’s social services agency is also a helpful resource when navigating the renewal process and some counties have even set up service centers to answer reenrollment questions in person. \u003ca href=\"#helpmedicaid\">Find contact information for your county’s social services agency (above).\u003c/a>\u003c/p>\n\u003ch2>\u003ca id=\"tellus\">\u003c/a>Tell us: What else do you need information about?\u003c/h2>\n\u003cp>At KQED News, we know that it can sometimes be hard to track down the answers to navigate life in the Bay Area in 2023. We’ve published \u003ca href=\"https://www.kqed.org/news/tag/coronavirus-resources-and-explainers\">clear, helpful explainers and guides about issues like COVID\u003c/a>, \u003ca href=\"https://www.kqed.org/news/11936674/how-to-prepare-for-this-weeks-atmospheric-river-storm-sandbags-emergency-kits-and-more\">how to cope with intense winter weather\u003c/a> and \u003ca href=\"https://www.kqed.org/news/11821950/how-to-safely-attend-a-protest-in-the-bay-area\">how to exercise your right to protest safely\u003c/a>.\u003c/p>\n\u003cp>So tell us: What do you need to know more about? Tell us, and you could see your question answered online or on social media. What you submit will make our reporting stronger, and help us decide what to cover here on our site, and on KQED Public Radio, too.\u003c/p>\n\u003cp>[hearken id=\"10483\" src=\"https://modules.wearehearken.com/kqed/embed/10483.js\"]\u003c/p>\n\u003cp>\u003cem>KQED’s Carly Severn contributed to this story.\u003c/em>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n","blocks":[],"excerpt":"Starting in April, Californians who depend on Medi-Cal will need to once again renew their eligibility. Here's what you need to know.","status":"publish","parent":0,"modified":1688413142,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":true,"hasPolis":false,"paragraphCount":50,"wordCount":2034},"headData":{"title":"On Medi-Cal? Eligibility Changes Starting in April Could Mean You Lose Coverage. Here's What to Do | KQED","description":"Starting in April, Californians who depend on Medi-Cal will need to once again renew their eligibility. Here's what you need to know.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":""},"excludeFromSiteSearch":"Include","articleAge":"0","path":"/news/11944543/on-medi-cal-eligibility-changes-starting-in-april-could-mean-you-lose-coverage-heres-what-to-do","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Starting April 1, Californians who depend on \u003ca href=\"https://www.dhcs.ca.gov/Pages/myMedi-Cal.aspx\">Medi-Cal\u003c/a> — the state’s Medicaid health care program — for their health care expenses will need to once again \u003ca href=\"https://www.dhcs.ca.gov/Pages/Keep-Your-Medi-Cal.aspx\">go through a redetermination process to renew their eligibility and keep their Medi-Cal coverage\u003c/a>.\u003c/p>\n\u003cp>Thanks to \u003ca href=\"https://www.hhs.gov/about/news/2023/02/09/fact-sheet-covid-19-public-health-emergency-transition-roadmap.html\">the federal COVID Public Health Emergency (PHE)\u003c/a> declared in 2020, Medicaid programs around the nation like Medi-Cal have been able to waive annual eligibility requirements. This means that for the past three years, Medicaid beneficiaries had their health care costs covered without having to go through an annual renewal process, which could have found them no longer eligible to receive Medicaid.\u003c/p>\n\u003cp>But at the end of last year, Congress approved the Consolidated Appropriations Act — putting \u003ca href=\"https://www.hhs.gov/about/news/2023/02/09/fact-sheet-covid-19-public-health-emergency-transition-roadmap.html\">an end date of March 31 on automatic Medicaid renewal\u003c/a>.\u003c/p>\n\u003cp>\u003cstrong>Jump to:\u003c/strong>\u003c/p>\n\u003cul>\n\u003cli>\u003cstrong>\u003ca href=\"#keepmedicaid\">What do I need to do to keep my Medi-Cal coverage?\u003c/a>\u003c/strong>\u003c/li>\n\u003cli>\u003cstrong>\u003ca href=\"#helpmedicaid\">Find my Bay Area county’s Medi-Cal office\u003c/a>\u003c/strong>\u003c/li>\n\u003c/ul>\n\u003ch2>Who will be affected by these Medi-Cal changes?\u003c/h2>\n\u003cp>This change will affect the millions of people nationwide who depend on Medicaid to cover essential care, prescriptions and other health care services, including the 12 million people enrolled in Medi-Cal within California.\u003c/p>\n\u003cp>The Urban Institute, a public policy think tank, released a study at the end of 2022 that estimates that \u003ca href=\"https://www.urban.org/research/publication/impact-covid-19-public-health-emergency-expiration-all-types-health-coverage\">18 million people nationwide may lose their Medicaid\u003c/a> coverage during a 14-month period following the end of the PHE — either because they are found to no longer qualify for Medi-Cal, or because they fail to renew on time. \u003ca href=\"https://www.dhcs.ca.gov/Documents/PHE-UOP/Medi-Cal-COVID-19-PHE-Unwinding-Plan.pdf\">In California, that number could be as high as 3 million.\u003c/a>\u003c/p>\n\u003cul>\n\u003cli>\u003cstrong>\u003ca href=\"#tellus\">Tell us: What else do you need information about right now?\u003c/a>\u003c/strong>\u003c/li>\n\u003c/ul>\n\u003cp>Disability rights advocates also worry that the renewal process could leave people without health coverage. “Administrative and procedural barriers can also lead to someone being dis-enrolled, with \u003ca href=\"https://www.teenvogue.com/story/medicaid-coverage-covid\">low-income people and people of color disproportionately at higher risk due to structural inequities\u003c/a>,” wrote San Francisco disability rights activist Alice Wong in a recent column for \u003cem>Teen Vogue.\u003c/em>\u003c/p>\n\u003cp>Individuals who received Medi-Cal benefits before the pandemic began may remember what it’s like to renew eligibility: Your county’s health and human services agency sends to your mailbox a thick packet full of forms to fill out and verify your residency, income, health information and other personal details.\u003c/p>\n\u003cp>But regardless of whether you have been on Medi-Cal for decades, or joined far more recently during the pandemic, \u003ca href=\"https://www.dhcs.ca.gov/Pages/Keep-Your-Medi-Cal.aspx\">the redetermination process will be required for all Medi-Cal beneficiaries\u003c/a>. This means that every single person on Medi-Cal needs to be aware of the coming changes starting in April, to make sure they keep health care coverage in some form.\u003c/p>\n\u003cp>Keep reading for what you need to know.\u003c/p>\n\u003cfigure id=\"attachment_11944676\" class=\"wp-caption alignnone\" style=\"max-width: 1920px\">\u003cimg decoding=\"async\" loading=\"lazy\" class=\"size-full wp-image-11944676\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/03/pexels-rodnae-productions-7821577.jpg\" alt=\"A photograph shot from behind of two people, whose faces we can't see, operating a laptop to fill out a form.\" width=\"1920\" height=\"1280\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2023/03/pexels-rodnae-productions-7821577.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/10/2023/03/pexels-rodnae-productions-7821577-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/10/2023/03/pexels-rodnae-productions-7821577-1020x680.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/10/2023/03/pexels-rodnae-productions-7821577-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/10/2023/03/pexels-rodnae-productions-7821577-1536x1024.jpg 1536w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Changes are coming to Medi-Cal eligibility, and you’ll have to act to keep coverage. \u003ccite>(RODNAE Productions/Pexels)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003ch2>\u003ca id=\"keepmedicaid\">\u003c/a>On Medi-Cal? Here’s what to expect starting April 1\u003c/h2>\n\u003cp>Nobody will be automatically dropped from their Medi-Cal coverage on April 1, says María Reyes, community health education manager for La Clínica de la Raza, which provides health services to lower-income communities in Alameda, Contra Costa and Solano counties.\u003c/p>\n\u003cp>Instead, that date marks the start of the process to reenroll people on Medi-Cal.\u003c/p>\n\u003cp>Once the Medi-Cal renewal waiver ends on March 31, there will be two ways people can renew their benefits: through the mail or \u003ca href=\"https://www.dhcs.ca.gov/Pages/Keep-Your-Medi-Cal.aspx\">online at the Medi-Cal website\u003c/a>. But it’s important to remember that the deadline to renew will be different for everyone, says Reyes.\u003c/p>\n\u003cp>The deadline to renew your personal coverage, she says, is based on your Medi-Cal “anniversary”:\u003c/p>\n\u003cul>\n\u003cli>If you had Medi-Cal \u003cstrong>before 2020\u003c/strong>, your anniversary is the date when you last renewed your coverage before the pandemic, but:\u003c/li>\n\u003cli>If you enrolled \u003cstrong>after 2020\u003c/strong> and haven’t gone through the renewal process yet, your anniversary falls on the date you first applied.\u003c/li>\n\u003c/ul>\n\u003cp>Reyes recommends that you confirm the exact date of your coverage anniversary — because you should receive a renewal packet in the mail ahead of this date.\u003c/p>\n\u003cp>\u003cstrong>Option 1: Renew your Medi-Cal coverage by mail\u003c/strong>\u003c/p>\n\u003cp>“As people meet their anniversary date, they’ll be getting these packets,” she says, adding that the packets will include a letter with information specific to your coverage. “This letter will let you know you have X amount of time, from the time you receive the letter, to submit your renewal packet and the documents they are requesting from you.”\u003c/p>\n\u003cp>\u003ca href=\"https://calmatters.org/health/2023/03/medi-cal-eligibility-2/\">These packets will be going out in phases monthly up through June 2024\u003c/a>, and will include \u003ca href=\"https://www.dhcs.ca.gov/formsandpubs/forms/Forms/mc210rv-eng.pdf\">an annual redetermination form (PDF)\u003c/a> which asks for information about a beneficiary’s income, living situation and disability status, among other factors. You may be asked to submit additional documents depending on your circumstances. You should fill it out and return it as soon as possible, if you don’t plan on renewing your Medi-Cal online (see Option 2).\u003c/p>\n\u003cp>“If, for some reason, your county office doesn’t get the packet by the deadline, they’ll send another reminder letter letting you know they haven’t received your documents,” Reyes said, adding that there may be a \u003cem>third\u003c/em> letter in the mail if a beneficiary misses the second deadline. There should, she assures, be several opportunities for people to be reminded of this deadline. “It’s not going to be a sudden stop of services,” she said.\u003c/p>\n\u003cp>\u003cstrong>Option 2: Renew your Medi-Cal coverage online\u003c/strong>\u003c/p>\n\u003cp>In some cases, you may be able to renew online. In the Bay Area, counties use either one of two renewal portals:\u003c/p>\n\u003cul>\n\u003cli>If you live in Alameda, San Francisco, San Mateo, Solano and Sonoma counties, visit \u003ca href=\"https://www.mybenefitscalwin.org/#/home\">MyBenefitsCalWin\u003c/a> to renew your Medi-Cal.\u003c/li>\n\u003cli>If you live in Contra Costa, Marin, Napa or Santa Clara counties, visit \u003ca href=\"https://benefitscal.com/\">BenefitsCal\u003c/a> to renew your Medi-Cal.\u003c/li>\n\u003c/ul>\n\u003cp>If you live somewhere else in California, \u003ca href=\"https://www.dhcs.ca.gov/Pages/Keep-Your-Medi-Cal.aspx\">see which website your county uses for your to renew your Medi-Cal\u003c/a>.\u003c/p>\n\u003ch2>What if I am found to no longer be eligible for Medi-Cal?\u003c/h2>\n\u003cp>If you don’t renew your Medi-Cal by the deadline (see Options 1 and 2, in the previous section), or are found to no longer be eligible, you’ll be removed from Medi-Cal coverage. And if that happens, you’ll have other options for subsidized health care coverage — but at a cost.\u003c/p>\n\u003cp>Yingjia Huang, assistant deputy director for health care benefits and eligibility at the Department of Health Care Services, told CalMatters that \u003ca href=\"https://calmatters.org/health/2023/03/medi-cal-eligibility-2/\">if you no longer qualify for Medi-Cal because your income has gone up, you’ll be “automatically” transitioned\u003c/a> into a similar plan through Covered California. “The system automatically will review their eligibility for Covered California, and Covered California will send out the enrollment notice to the member, informing them of their options and to pay the plan premium,” said Huang. There’ll be “no administrative burden on a member,” she stressed.\u003c/p>\n\u003cp>But of course, this may come with a new monthly premium that many folks on Medi-Cal haven’t had to pay before — and might not feel able to when factoring in their other expenses.\u003c/p>\n\u003cp>The state emphasizes that \u003ca href=\"https://www.coveredca.com/marketing-blog/health-insurance-costs-less-thanks-to-the-inflation-reduction-act/\">nearly half of people getting health care through Covered California pay less than $50\u003c/a>, while nearly a quarter of people don’t pay a monthly premium at all.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003ch2>What happens if I don’t get my renewal packet in the mail?\u003c/h2>\n\u003cp>Reyes is keen to reiterate that no one will be automatically dropped from their Medi-Cal coverage on April 1. “Starting on that date, people should be on the lookout for these renewal packages that they will need to complete,” she said.\u003c/p>\n\u003cp>If your coverage anniversary rolls around and you have not received a renewal packet, there may be several possibilities to explain why:\u003c/p>\n\u003cul>\n\u003cli>You may have the wrong date on file for your anniversary, or:\u003c/li>\n\u003cli>Your county may be sending the packet to an old address (more likely \u003ca href=\"https://www.sfhsa.org/services/health/medi-cal/renew-your-medi-cal-coverage\">if you moved during the pandemic\u003c/a>).\u003c/li>\n\u003c/ul>\n\u003cp>In either case, you should confirm your information with your county directly. You can do this online:\u003c/p>\n\u003cul>\n\u003cli>If you live in Alameda, San Francisco, San Mateo, Solano and Sonoma counties, visit \u003ca href=\"https://www.mybenefitscalwin.org/#/home\">MyBenefitsCalWin\u003c/a> to update your Medi-Cal contact information.\u003c/li>\n\u003cli>If you live in Contra Costa, Marin, Napa or Santa Clara counties, visit \u003ca href=\"https://benefitscal.com/\">BenefitsCal\u003c/a> to update your Medi-Cal contact information.\u003c/li>\n\u003c/ul>\n\u003cp>You can also contact the office in your county that manages Medi-Cal enrollment. Find your county in the list below.\u003c/p>\n\u003ch2>\u003ca id=\"helpmedicaid\">\u003c/a>Get direct assistance with Medi-Cal and update your contact details\u003c/h2>\n\u003cp>\u003cstrong>Alameda County\u003c/strong>: \u003ca href=\"https://www.alamedacountysocialservices.org/our-services/Health-and-Food/Medi-Cal/index\">Social Services Agency\u003c/a>, 24100 Amador Street, Hayward; call (888) 999-4772.\u003c/p>\n\u003cp>\u003cstrong>Contra Costa County\u003c/strong>: \u003ca href=\"https://ehsd.org/benefits/medi-cal-and-health-coverage-options/\">Employment and Human Services\u003c/a>, multiple addresses; call (866) 663-3225.\u003c/p>\n\u003cp>\u003cstrong>Marin County\u003c/strong>: \u003ca href=\"https://www.marinhhs.org/medi-cal\">Health and Human Services\u003c/a>, 120 N. Redwood Drive, San Rafael; call (877) 410-8817.\u003c/p>\n\u003cp>\u003cstrong>Napa County\u003c/strong>: \u003ca href=\"https://www.countyofnapa.org/3304/Self-Sufficiency-Services\">Health and Human Services\u003c/a>, 2751 Napa Valley Corporate Drive, Napa; call (707) 253-4511.\u003c/p>\n\u003cp>\u003cstrong>San Francisco\u003c/strong>: \u003ca href=\"https://www.sfhsa.org/services/health/medi-cal/renew-your-medi-cal-coverage\">Human Services Agency\u003c/a>, 1440 Harrison Street, San Francisco; call (415) 558-4700.\u003c/p>\n\u003cp>\u003cstrong>San Mateo County\u003c/strong>: \u003ca href=\"https://www.smcgov.org/hsa/health-coverage\">Human Services\u003c/a>, 400 Harbor Boulevard, Building B, Belmont; call (800) 223-8383.\u003c/p>\n\u003cp>\u003cstrong>Santa Clara County\u003c/strong>: \u003ca href=\"https://socialservices.sccgov.org/health-coverage\">Social Services Agency\u003c/a>, 1867 Senter Road, San José; call (408) 758-3800.\u003c/p>\n\u003cp>\u003cstrong>Solano County\u003c/strong>: \u003ca href=\"https://www.solanocounty.com/depts/hss/ees/medical/default.asp\">Health and Social Services\u003c/a>, multiple addresses; call (707) 784-3900.\u003c/p>\n\u003cp>\u003cstrong>Sonoma County\u003c/strong>: \u003ca href=\"https://sonomacounty.ca.gov/health-and-human-services/human-services/divisions-and-services/economic-assistance/health-care-benefits/medi-cal-and-county-medical-services-program\">Department of Human Services\u003c/a>, 2550 Paulin Drive, Santa Rosa, or 5350 Old Redwood Highway, Suite 100, Petaluma; call (877) 699-6868.\u003c/p>\n\u003ch2>Remember, you don’t have to go through this alone\u003c/h2>\n\u003cp>If you are a parent or caregiver and managing a family all by yourself, working multiple jobs or managing a chronic illness, the Medi-Cal renewal process is another item on a long list of responsibilities you are already juggling. You might also be facing \u003ca href=\"https://www.kqed.org/news/11943420/your-calfresh-benefits-will-drop-in-april-heres-what-you-can-do\">a drop in your CalFresh benefits (SNAP, or food stamps)\u003c/a> at the same time as this Medi-Cal renewal, starting in April.\u003c/p>\n\u003cp>Many organizations across California are helping folks send their renewal packets in on time and keep their coverage. One of them is La Clínica de la Raza, which has set up a service that provides individual assistance to Medi-Cal recipients living in Alameda, Contra Costa or Solano counties while completing the renewal requirements.\u003c/p>\n\u003cp>“We don’t want people to lose coverage, especially because preventative services are important — particularly for those who have chronic conditions,” said Reyes, from La Clínica. “We want to make sure that they’re not at risk of losing coverage, not being able to see their provider, not able to refill their prescriptions. So taking action as soon as possible is important.”\u003c/p>\n\u003cp>If you are on Medi-Cal and live in Alameda, Contra Costa or Solano counties, contact La Clínica de la Raza at (855) 494-4658. Help is available in both English and Spanish.\u003c/p>\n\u003cp>Reyes adds that your county’s social services agency is also a helpful resource when navigating the renewal process and some counties have even set up service centers to answer reenrollment questions in person. \u003ca href=\"#helpmedicaid\">Find contact information for your county’s social services agency (above).\u003c/a>\u003c/p>\n\u003ch2>\u003ca id=\"tellus\">\u003c/a>Tell us: What else do you need information about?\u003c/h2>\n\u003cp>At KQED News, we know that it can sometimes be hard to track down the answers to navigate life in the Bay Area in 2023. We’ve published \u003ca href=\"https://www.kqed.org/news/tag/coronavirus-resources-and-explainers\">clear, helpful explainers and guides about issues like COVID\u003c/a>, \u003ca href=\"https://www.kqed.org/news/11936674/how-to-prepare-for-this-weeks-atmospheric-river-storm-sandbags-emergency-kits-and-more\">how to cope with intense winter weather\u003c/a> and \u003ca href=\"https://www.kqed.org/news/11821950/how-to-safely-attend-a-protest-in-the-bay-area\">how to exercise your right to protest safely\u003c/a>.\u003c/p>\n\u003cp>So tell us: What do you need to know more about? Tell us, and you could see your question answered online or on social media. What you submit will make our reporting stronger, and help us decide what to cover here on our site, and on KQED Public Radio, too.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"hearken","attributes":{"named":{"id":"10483","src":"https://modules.wearehearken.com/kqed/embed/10483.js","label":""},"numeric":[]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>KQED’s Carly Severn contributed to this story.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/news/11944543/on-medi-cal-eligibility-changes-starting-in-april-could-mean-you-lose-coverage-heres-what-to-do","authors":["11708"],"categories":["news_457","news_8"],"tags":["news_32707","news_29029","news_27626","news_18543","news_683","news_2605","news_20666"],"featImg":"news_11944683","label":"news"},"news_11942493":{"type":"posts","id":"news_11942493","meta":{"index":"posts_1591205157","site":"news","id":"11942493","score":null,"sort":[1677938438000]},"guestAuthors":[],"slug":"californias-massive-medicaid-program-works-for-some-but-fails-many-others","title":"California's Massive Medicaid Program Works for Some, but Fails Many Others","publishDate":1677938438,"format":"standard","headTitle":"California Healthline | KQED News","labelTerm":{"term":20286,"site":"news"},"content":"\u003cp>Newborns. Formerly incarcerated people. College students. Pregnant people. People with disabilities. Foster kids. Unhoused people. Single dads.\u003c/p>\n\u003cp>Your neighbor. Your co-worker.\u003c/p>\n\u003cp>You.\u003c/p>\n\u003cp>California’s Medicaid program, called Medi-Cal, serves a whopping 15.4 million people, offering care from cradle to grave: \u003ca href=\"https://www.chcf.org/publication/2021-edition-medi-cal-facts-figures/\">Half of all births are covered by Medi-Cal\u003c/a>, as are more than half of all stays in nursing homes.\u003c/p>\n\u003cp>Everything about Medi-Cal is massive, from its \u003ca href=\"https://ebudget.ca.gov/2023-24/pdf/BudgetSummary/HealthandHumanServices.pdf\">upcoming fiscal year budget of $139 billion (PDF)\u003c/a> to the expansive list of benefits and services it offers. The way the program works — or doesn’t — could spell life or death for many enrollees.\u003c/p>\n\u003cp>“It’s critical, from the single pregnant mom, to the extremely frail elderly population that needs a nursing home,” said Jennifer Kent, former director of the state Department of Health Care Services, which administers Medi-Cal. “If it weren’t for Medi-Cal, so many people would either be dead or would be severely compromised.”\u003c/p>\n\u003cp>In a new series, California Healthline will shed light on Medi-Cal’s successes and failures through the experiences of its enrollees. They include Stephanie Lammers, who can’t get her troubling abdominal symptoms checked at a clinic 50 miles from her small Calaveras County town because the transportation Medi-Cal is supposed to provide isn’t trustworthy; Carolina Morga Tapia, a Fresno woman who credits Medi-Cal with helping her have five healthy children; and Lucas Moreno Ramirez, a Los Angeles County man with stage 4 lung cancer who had to fight to keep his treatment going.\u003c/p>\n\u003cp>Medi-Cal is at a critical juncture as it attempts to serve the needs of a diverse patient population with a dizzying array of medical needs — from childhood vaccinations and cancer screenings to state-of-the-art care for rare genetic disorders. \u003ca href=\"https://www.dhcs.ca.gov/dataandstats/statistics/Documents/FastFacts-March2022.pdf\">Roughly half of enrollees are Hispanic (PDF)\u003c/a>, and, next year, \u003ca href=\"https://californiahealthline.org/news/article/covered-california-bill-undocumented-immigrant-health-insurance/\">California will become the first state to expand eligibility to all immigrants who qualify, regardless of their legal status\u003c/a>.[aside postID=news_11926757 hero='https://ww2.kqed.org/app/uploads/sites/10/2022/09/GettyImages-1340030341.jpg']Medi-Cal is also undertaking several new initiatives that aim to save taxpayer money and improve quality. State \u003ca href=\"https://khn.org/news/article/californias-reboot-of-troubled-medi-cal-puts-pressure-on-health-plans/\">officials are demanding that the 23 health insurers that serve most Medi-Cal patients provide better care\u003c/a> — or face significant penalties, including potential expulsion from the program.\u003c/p>\n\u003cp>The state is also \u003ca href=\"https://khn.org/news/article/california-medicaid-makeover-newsom-california-medi-cal-homeless-public-funds/\">adding innovative social services\u003c/a> that fall outside the traditional realm of medicine, including helping some enrollees pay for rent and buy groceries.\u003c/p>\n\u003cp>“People are watching California,” said Cindy Mann, who served as federal Medicaid director under former President Barack Obama. “What the state is doing is ambitious and very aggressive. It makes a significant mark on health care and health policy, not just because of the size and breadth of its program, but by being very comprehensive.”\u003c/p>\n\u003cp>But only a sliver of enrollees will get the new social services, even as \u003ca href=\"https://khn.org/news/article/california-governor-newsom-pricey-medicaid-reforms-leave-most-patients-behind/\">many patients struggle to obtain basic care\u003c/a> or get in to see their doctors. In reality, the type of care you get in Medi-Cal depends on where you live and which insurer provides your benefits.\u003c/p>\n\u003cp>That means the program is working for some, but failing for many others.\u003c/p>\n\u003cp>If you are in Medi-Cal, \u003ca href=\"https://californiahealthline.org/faces-of-medi-cal-submissions/\">we would like to hear from you\u003c/a>, whether you live in a big city or a rural region, regardless of your age, race or ethnicity, and whatever your medical, dental or mental health condition. Have you had difficulty seeing the right doctor for what ails you, even to the point of putting your life at risk? Or did Medi-Cal provide good care, perhaps sparing you serious harm or disability? Either way, \u003ca href=\"https://californiahealthline.org/faces-of-medi-cal-submissions/\">please consider sharing your experience with us\u003c/a>.\u003c/p>\n\u003cp>Here are snapshots of patients who have used the program at a critical time in their lives.\u003c/p>\n\u003ch2>'I just don't go to the doctor anymore'\u003c/h2>\n\u003cp>When Stephanie Lammers leans over to put on her shoes, it feels as if she’s squishing something inside her abdomen, she said.\u003c/p>\n\u003cp>Lammers, 53, has been suffering from frequent bouts of nausea, pain and bloating for six months.\u003c/p>\n\u003cp>Her gastroenterologist wants to perform diagnostic procedures, including a colonoscopy and, if anything shows up, a biopsy. But Lammers, who lives in a motel with her boyfriend and teenage daughter in the Gold Rush town of San Andreas, doesn’t have a working car and can’t readily get to the clinic — which is 50 miles away.\u003c/p>\n\u003cfigure id=\"attachment_11942519\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg decoding=\"async\" loading=\"lazy\" class=\"wp-image-11942519 size-medium\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/03/Lammers_04-800x548.jpg\" alt=\"A middle-aged white woman with a long-sleeved shirt with horizontal blue-and-white stripes, with one shoulder pulled down to reveal a tattoo of an eye, looks at the camera as she leans against a door jamb. To her left, a white husky dog looks out from a window.\" width=\"800\" height=\"548\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2023/03/Lammers_04-800x548.jpg 800w, https://ww2.kqed.org/app/uploads/sites/10/2023/03/Lammers_04-1020x699.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/10/2023/03/Lammers_04-160x110.jpg 160w, https://ww2.kqed.org/app/uploads/sites/10/2023/03/Lammers_04-1536x1052.jpg 1536w, https://ww2.kqed.org/app/uploads/sites/10/2023/03/Lammers_04-2048x1402.jpg 2048w, https://ww2.kqed.org/app/uploads/sites/10/2023/03/Lammers_04-1920x1315.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Stephanie Lammers says the ride service provided by her Medi-Cal health plan is so bad that she stopped trying to use it about a year ago, after it left her in the lurch multiple times. 'I just don't go to the doctor anymore,' she says. \u003ccite>(Rich Pedroncelli/KHN)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>For Lammers, like many Medi-Cal enrollees who live in rural areas, lack of transportation is a major impediment to obtaining care. The problem is particularly acute for patients who need to see specialists.\u003c/p>\n\u003cp>Lammers’ dermatologist and eye doctor are over an hour away from San Andreas, the county seat of Calaveras County, about 125 miles northeast of San Francisco. She isn’t seeing a neurologist, despite a series of mini-strokes and stress-related seizures. And she hasn’t been to a podiatrist in two years, even though her toes are twisted over one another and hang down, causing her to trip. She’s often in excruciating pain when she walks.\u003c/p>\n\u003cp>Medi-Cal is supposed to provide \u003ca href=\"https://www.dhcs.ca.gov/services/medi-cal/Pages/Transportation.aspx\">free transportation to enrollees\u003c/a> who can’t otherwise get to their appointments.\u003c/p>\n\u003cp>But Lammers — whose health plan is California Health and Wellness, owned by Centene, \u003ca href=\"https://khn.org/news/article/centene-political-donations-medicaid-contracts-overbilling-allegations/\">the nation’s largest commercial Medicaid insurer\u003c/a> — stopped using its ride service nearly a year ago, after she missed dozens of appointments because drivers just didn’t show up, she said. She was getting threatening letters from doctors’ offices over the no-shows.\u003c/p>\n\u003cp>Once, she had to hitchhike more than 30 miles home from a counseling appointment. On other occasions, Lammers said, she did not receive the reimbursement she was owed for arranging her own rides.\u003c/p>\n\u003cp>“I just don’t go to the doctor anymore,” Lammers said. “If I go to the doctor, my boyfriend has to take the day off work, and if he takes the day off work, we have no money.”\u003c/p>\n\u003cp>During the last three months of 2022, Lammers canceled five appointments she had scheduled for the diagnostic abdominal procedures because her boyfriend had to work each time and couldn’t take her. She finally stopped rescheduling.\u003c/p>\n\u003cp>California Health and Wellness contracts with ModivCare, a Denver-based medical transportation company that is no stranger to \u003ca href=\"https://khn.org/news/article/medicaid-transportation-nonemergency-benefit-patients-stranded/\">patient complaints and lawsuits\u003c/a>.\u003c/p>\n\u003cp>Before she gave up on the ride service, Lammers said, she would call California Health and Wellness to try to resolve the issue, only to be told that ModivCare was a separate company. “I’m like, ‘If you guys hired them and put them in charge of transportation, who oversees their screwups?,’” she said.\u003c/p>\n\u003cfigure id=\"attachment_11942520\" class=\"wp-caption alignright\" style=\"max-width: 800px\">\u003cimg decoding=\"async\" loading=\"lazy\" class=\"wp-image-11942520 size-medium\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/03/Lammers_09-800x614.jpg\" alt=\"A white woman, standing in a crowded room of unmade beds, dishes potatoes onto a plate of biscuits and gravy from a hot plate on a cabinet next to a fridge. \" width=\"800\" height=\"614\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2023/03/Lammers_09-800x614.jpg 800w, https://ww2.kqed.org/app/uploads/sites/10/2023/03/Lammers_09-1020x783.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/10/2023/03/Lammers_09-160x123.jpg 160w, https://ww2.kqed.org/app/uploads/sites/10/2023/03/Lammers_09-1536x1180.jpg 1536w, https://ww2.kqed.org/app/uploads/sites/10/2023/03/Lammers_09-2048x1573.jpg 2048w, https://ww2.kqed.org/app/uploads/sites/10/2023/03/Lammers_09-1920x1475.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Stephanie Lammers has serious abdominal symptoms, and her gastroenterologist wants to run diagnostic tests, but she had to cancel five appointments in the last three months of 2022 because she didn't have transportation. \u003ccite>(Rich Pedroncelli/KHN)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Courtney Schwyzer, a member of a legal aid team representing Lammers on various Medi-Cal matters, said the failure of medical ride services is a systemic problem. In late February, Schwyzer and her fellow attorneys filed a petition in court that she hopes will force the state Department of Health Care Services to address the problem.\u003c/p>\n\u003cp>California Health and Wellness spokesperson Darrel Ng said the company monitors the quality of its contractors, but a shortage of transportation providers in rural areas “has created unique challenges.”\u003c/p>\n\u003cp>ModivCare provides more than 4 million rides for Medi-Cal recipients annually, and more than 99% are without complaint, said Melody Lai, a company spokesperson.\u003c/p>\n\u003cp>Lammers, who is unemployed and trying to start a custom craft business called Stuff by Steph, said doctors have warned her that if she doesn’t reduce her stress level, it could shorten her life. But arranging medical care is the most stressful thing in her life right now, so she doesn’t try anymore.\u003c/p>\n\u003cp>“In order to keep from dying, I have to not go to the doctor,” she said.\u003c/p>\n\u003ch2>'It's a blessing'\u003c/h2>\n\u003cp>Medi-Cal helped save the life of Carolina Morga Tapia, a 30-year-old full-time mother of five who lives with her family amid almond groves in an agricultural enclave of Fresno.\u003c/p>\n\u003cp>Nine years ago, a bacterial infection triggered premature labor during the 25th week of her second pregnancy, and Morga Tapia almost died. She spiked a fever, bled profusely and needed immediate transfusions and emergency surgery. After several days in critical care, she fully recovered.\u003c/p>\n\u003cfigure id=\"attachment_11942521\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg decoding=\"async\" loading=\"lazy\" class=\"wp-image-11942521 size-medium\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/03/carolina_tapia-2-800x534.jpg\" alt=\"A Latina woman with a blue cardigan and a black shirt looks at the camera, arms akimbo, standing in a leafless orchard.\" width=\"800\" height=\"534\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2023/03/carolina_tapia-2-800x534.jpg 800w, https://ww2.kqed.org/app/uploads/sites/10/2023/03/carolina_tapia-2-1020x681.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/10/2023/03/carolina_tapia-2-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/10/2023/03/carolina_tapia-2-1536x1025.jpg 1536w, https://ww2.kqed.org/app/uploads/sites/10/2023/03/carolina_tapia-2-2048x1367.jpg 2048w, https://ww2.kqed.org/app/uploads/sites/10/2023/03/carolina_tapia-2-1920x1281.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Carolina Morga Tapia stands amid almond trees outside her home in Fresno. She, her husband and their five children are enrolled in Medi-Cal, and she says she is very happy with the care it has provided, including emergency surgery that saved her life after she fell gravely ill during her second pregnancy. \u003ccite>(Heidi de Marco/KHN)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>But the doctors could not stop the premature birth, and her baby came out weighing just 1 pound. She and her husband, David Nuñez, named her Milagros Guadalupe, and she died four days later, on Sept. 13, 2013.\u003c/p>\n\u003cp>In each of her subsequent pregnancies, Medi-Cal paid for Morga Tapia to get shots of synthetic progesterone, intended to prevent another preterm birth. Those shots — one a week for about 20 weeks — can cost an average of \u003ca href=\"https://www.npr.org/sections/health-shots/2020/01/24/798731110/drug-to-prevent-premature-birth-divides-doctors-insurers-and-fda-experts\">more than $10,000 per pregnancy\u003c/a>.\u003c/p>\n\u003cp>Morga Tapia and Nuñez, a construction worker, signed up for Medi-Cal when she was pregnant with her first child more than a decade ago. They’ve been on the same Anthem Blue Cross Medi-Cal plan ever since.\u003c/p>\n\u003cp>The plan paid for prenatal care through all six of Morga Tapia’s pregnancies, and it has provided all the medical and dental care the family needs, she said.\u003c/p>\n\u003cp>“Without Medi-Cal, we would have to be paying for all of our children,” said Morga Tapia. “It saves a lot of money, and it’s a blessing to have that extra help.”\u003c/p>\n\u003cp>Her children, four girls and a boy, range in age from 1 to 10. They all go to the same children’s clinic and see the same pediatrician.[pullquote align=\"right\" size=\"medium\" citation=\"Carolina Morga Tapia\"]'Without Medi-Cal, we would have to be paying for all of our children. It saves a lot of money, and it's a blessing to have that extra help.'[/pullquote]The kids, all in good health, get routine checkups, vaccinations and other preventive care, Morga Tapia said. She gets appointment reminders via text and cards in the mail notifying her when it’s time for the kids’ vaccinations and wellness checks, as well as her Pap smears, she said.\u003c/p>\n\u003cp>Her family’s experience contrasts sharply with the state’s assessment of their health plan, according to a \u003ca href=\"https://www.dhcs.ca.gov/dataandstats/reports/Documents/Enhancing-Quality-for-Medi-Cal-Members.pdf\">report on quality of care in Medi-Cal issued late last year (PDF)\u003c/a>. The report, which evaluated Medi-Cal health plans on pediatric care, women’s health and chronic disease management, put Anthem Blue Cross in the lowest tier, and below par on multiple measures in numerous counties, including Fresno.\u003c/p>\n\u003cp>Another state report, released in late January, detailed how quickly insurers provide appointments for their patients, and put \u003ca href=\"https://www.dmhc.ca.gov/Portals/0/Docs/OPM/MY2021TAR.pdf\">Anthem Blue Cross’ Medi-Cal plan near the bottom of the heap (PDF)\u003c/a>.\u003c/p>\n\u003cp>Anthem Blue Cross spokesperson Michael Bowman said in a statement that the period covered in the reports coincide with the COVID-19 pandemic, “when our safety net providers dealt with significant challenges with workforce and appointment availability.”\u003c/p>\n\u003cp>Morga Tapia doesn’t give the insurer low marks. “It’s different for everybody. I have a good, healthy family, and what Medi-Cal covers is really fortunate for us,” she said.\u003c/p>\n\u003ch2>'I don't want to die yet'\u003c/h2>\n\u003cp>In late 2021, doctors gave Lucas Moreno Ramirez a few months to live.\u003c/p>\n\u003cp>Struggling with diabetes and late-stage lung cancer, Moreno Ramirez suffered debilitating pain as he hacked and labored for breath. His doctors recommended that he stop treatment and start hospice care.\u003c/p>\n\u003cp>He felt as if they were giving up on him.\u003c/p>\n\u003cp>“They said they’re going to give me opioids for my pain and help me have a comfortable death,” said Moreno Ramirez, 68, who lives in Norwalk, in Los Angeles County. “I told them I don’t believe in that. I don’t want to die yet.”\u003c/p>\n\u003cfigure id=\"attachment_11942525\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg decoding=\"async\" loading=\"lazy\" class=\"wp-image-11942525 size-medium\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/03/lucas_ramirez-3-800x534.jpg\" alt=\"A middle-aged Latino man, with a bushy gray mustache and thick gray hair combed back from his forehead, sits at a long table along a wall, on the other side of which a gauzy white curtain blows inward. He rests his right arm on the table, holding a blue-and-white mug. He looks at the camera, and is surrounded by cabinets with CDs, a massive water bottle, salt-and-pepper shakers, a clock on the wall and a nearby wind chime, and other homey detritus.\" width=\"800\" height=\"534\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2023/03/lucas_ramirez-3-800x534.jpg 800w, https://ww2.kqed.org/app/uploads/sites/10/2023/03/lucas_ramirez-3-1020x681.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/10/2023/03/lucas_ramirez-3-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/10/2023/03/lucas_ramirez-3-1536x1025.jpg 1536w, https://ww2.kqed.org/app/uploads/sites/10/2023/03/lucas_ramirez-3-2048x1367.jpg 2048w, https://ww2.kqed.org/app/uploads/sites/10/2023/03/lucas_ramirez-3-1920x1281.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Lucas Moreno Ramirez, a former landscaper and factory worker, has been diagnosed with both diabetes and lung cancer. Working alongside a care manager through his Medi-Cal managed-care plan, he has fought for better care and treatment for both conditions. \u003ccite>(Heidi de Marco/KHN)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>A former landscaper and factory worker, Moreno Ramirez learned he had to be his own advocate, fighting for the care he believed he deserved from Medi-Cal.\u003c/p>\n\u003cp>He said his Christian faith gave him strength, and over the next few months, he pushed the program and his doctors to keep battling his cancer, using a different treatment with fewer side effects than chemotherapy.\u003c/p>\n\u003cp>“I believe in prayer,” he said. “But I believe in science and medication, too.”\u003c/p>\n\u003cp>Moreno Ramirez is one of the \u003ca href=\"https://www.chcf.org/publication/in-alignment-calaims-plan-coordinate-care-dual-enrollees-medicare-medi-cal/\">roughly 1.6 million Californians enrolled in both Medicare, which covers people who are 65 and older or have disabilities, and Medi-Cal\u003c/a>, which \u003ca href=\"https://www.kff.org/medicare/issue-brief/a-profile-of-medicare-medicaid-enrollees-dual-eligibles/?utm_campaign=KFF-2023-Medicaid&utm_medium=email&_hsmi=243959452&_hsenc=p2ANqtz--_YdJIpoiPQ6BsTqKV7XWKRpOoR_sJTFFsZI7MrJWw-BvXTcEh0PRgAq42XpbIvOpISMXOG8GW_lDUH-w2IgL2Syf6YA&utm_content=243959452&utm_source=hs_email\">kicks in to cover the costs and benefits that Medicare doesn’t\u003c/a>.\u003c/p>\n\u003cp>He also relies on his Medi-Cal insurer to help him navigate the Byzantine system. L.A. Care, the largest Medi-Cal plan with nearly 2.6 million members, connected him with a care manager who worked with him to identify \u003ca href=\"https://www.cancer.gov/publications/dictionaries/cancer-terms/def/tagrisso\">a different treatment called Tagrisso\u003c/a> and advocated for him to get it.[aside label=\"Related Stories\" postID=\"news_11940023,news_11941075,news_1981588\"]Even with the new medication, Moreno Ramirez’s coughing fits returned last year, and his symptoms grew so painful he suspected the cancer was growing. He asked to see his pulmonologist but was told the first appointment would be in June 2023. So he switched doctors and scored an appointment nearly six months sooner.\u003c/p>\n\u003cp>“My old doctor didn’t help me. I didn’t trust him,” Moreno Ramirez said. “He was always too busy for me. I told my doctors, ‘Give me a chance.’”\u003c/p>\n\u003cp>Having taken his care into his own hands, he says he’s not in pain, his cough has subsided and he feels hopeful for the future. “Now I feel good,” he said.\u003c/p>\n\u003cp>He has also sought more attention for his diabetes and received a continuous glucose monitor to measure his blood sugar. It’s better controlled now than it has been in decades, he said.\u003c/p>\n\u003cp>“You have to stand up for yourself and advocate,” said Joann Pacelo, the care manager who helped Moreno Ramirez change doctors, get quicker referrals to specialists and get approved for in-home nursing visits.\u003c/p>\n\u003cp>“A lot of times, it’s difficult with Medi-Cal because the doctors are busy and the reimbursements are so low, but no one should be denied the care they deserve.”\u003c/p>\n\u003cp>\u003cem>California Healthline is a service of the California Health Care Foundation produced by Kaiser Health News.\u003c/em>\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n","blocks":[],"excerpt":"Serving over 15 million people and with an annual budget of $139 billion, California's massive Medicaid program — Medi-Cal — is at a critical juncture as it attempts to serve the needs of a diverse patient population with a dizzying array of medical needs.","status":"publish","parent":0,"modified":1678133816,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":60,"wordCount":2687},"headData":{"title":"California's Massive Medicaid Program Works for Some, but Fails Many Others | KQED","description":"Serving over 15 million people and with an annual budget of $139 billion, California's massive Medicaid program — Medi-Cal — is at a critical juncture as it attempts to serve the needs of a diverse patient population with a dizzying array of medical needs.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":""},"nprByline":"\u003ca href=\"https://californiahealthline.org/news/author/angela-hart/\">Angela Hart\u003c/a> and \u003ca href=\"https://californiahealthline.org/news/author/bernard-j-wolfson/\">Bernard J. Wolfson\u003c/a>","excludeFromSiteSearch":"Include","showOnAuthorArchivePages":"No","articleAge":"0","path":"/news/11942493/californias-massive-medicaid-program-works-for-some-but-fails-many-others","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Newborns. Formerly incarcerated people. College students. Pregnant people. People with disabilities. Foster kids. Unhoused people. Single dads.\u003c/p>\n\u003cp>Your neighbor. Your co-worker.\u003c/p>\n\u003cp>You.\u003c/p>\n\u003cp>California’s Medicaid program, called Medi-Cal, serves a whopping 15.4 million people, offering care from cradle to grave: \u003ca href=\"https://www.chcf.org/publication/2021-edition-medi-cal-facts-figures/\">Half of all births are covered by Medi-Cal\u003c/a>, as are more than half of all stays in nursing homes.\u003c/p>\n\u003cp>Everything about Medi-Cal is massive, from its \u003ca href=\"https://ebudget.ca.gov/2023-24/pdf/BudgetSummary/HealthandHumanServices.pdf\">upcoming fiscal year budget of $139 billion (PDF)\u003c/a> to the expansive list of benefits and services it offers. The way the program works — or doesn’t — could spell life or death for many enrollees.\u003c/p>\n\u003cp>“It’s critical, from the single pregnant mom, to the extremely frail elderly population that needs a nursing home,” said Jennifer Kent, former director of the state Department of Health Care Services, which administers Medi-Cal. “If it weren’t for Medi-Cal, so many people would either be dead or would be severely compromised.”\u003c/p>\n\u003cp>In a new series, California Healthline will shed light on Medi-Cal’s successes and failures through the experiences of its enrollees. They include Stephanie Lammers, who can’t get her troubling abdominal symptoms checked at a clinic 50 miles from her small Calaveras County town because the transportation Medi-Cal is supposed to provide isn’t trustworthy; Carolina Morga Tapia, a Fresno woman who credits Medi-Cal with helping her have five healthy children; and Lucas Moreno Ramirez, a Los Angeles County man with stage 4 lung cancer who had to fight to keep his treatment going.\u003c/p>\n\u003cp>Medi-Cal is at a critical juncture as it attempts to serve the needs of a diverse patient population with a dizzying array of medical needs — from childhood vaccinations and cancer screenings to state-of-the-art care for rare genetic disorders. \u003ca href=\"https://www.dhcs.ca.gov/dataandstats/statistics/Documents/FastFacts-March2022.pdf\">Roughly half of enrollees are Hispanic (PDF)\u003c/a>, and, next year, \u003ca href=\"https://californiahealthline.org/news/article/covered-california-bill-undocumented-immigrant-health-insurance/\">California will become the first state to expand eligibility to all immigrants who qualify, regardless of their legal status\u003c/a>.\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"aside","attributes":{"named":{"postid":"news_11926757","hero":"https://ww2.kqed.org/app/uploads/sites/10/2022/09/GettyImages-1340030341.jpg","label":""},"numeric":[]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>Medi-Cal is also undertaking several new initiatives that aim to save taxpayer money and improve quality. State \u003ca href=\"https://khn.org/news/article/californias-reboot-of-troubled-medi-cal-puts-pressure-on-health-plans/\">officials are demanding that the 23 health insurers that serve most Medi-Cal patients provide better care\u003c/a> — or face significant penalties, including potential expulsion from the program.\u003c/p>\n\u003cp>The state is also \u003ca href=\"https://khn.org/news/article/california-medicaid-makeover-newsom-california-medi-cal-homeless-public-funds/\">adding innovative social services\u003c/a> that fall outside the traditional realm of medicine, including helping some enrollees pay for rent and buy groceries.\u003c/p>\n\u003cp>“People are watching California,” said Cindy Mann, who served as federal Medicaid director under former President Barack Obama. “What the state is doing is ambitious and very aggressive. It makes a significant mark on health care and health policy, not just because of the size and breadth of its program, but by being very comprehensive.”\u003c/p>\n\u003cp>But only a sliver of enrollees will get the new social services, even as \u003ca href=\"https://khn.org/news/article/california-governor-newsom-pricey-medicaid-reforms-leave-most-patients-behind/\">many patients struggle to obtain basic care\u003c/a> or get in to see their doctors. In reality, the type of care you get in Medi-Cal depends on where you live and which insurer provides your benefits.\u003c/p>\n\u003cp>That means the program is working for some, but failing for many others.\u003c/p>\n\u003cp>If you are in Medi-Cal, \u003ca href=\"https://californiahealthline.org/faces-of-medi-cal-submissions/\">we would like to hear from you\u003c/a>, whether you live in a big city or a rural region, regardless of your age, race or ethnicity, and whatever your medical, dental or mental health condition. Have you had difficulty seeing the right doctor for what ails you, even to the point of putting your life at risk? Or did Medi-Cal provide good care, perhaps sparing you serious harm or disability? Either way, \u003ca href=\"https://californiahealthline.org/faces-of-medi-cal-submissions/\">please consider sharing your experience with us\u003c/a>.\u003c/p>\n\u003cp>Here are snapshots of patients who have used the program at a critical time in their lives.\u003c/p>\n\u003ch2>'I just don't go to the doctor anymore'\u003c/h2>\n\u003cp>When Stephanie Lammers leans over to put on her shoes, it feels as if she’s squishing something inside her abdomen, she said.\u003c/p>\n\u003cp>Lammers, 53, has been suffering from frequent bouts of nausea, pain and bloating for six months.\u003c/p>\n\u003cp>Her gastroenterologist wants to perform diagnostic procedures, including a colonoscopy and, if anything shows up, a biopsy. But Lammers, who lives in a motel with her boyfriend and teenage daughter in the Gold Rush town of San Andreas, doesn’t have a working car and can’t readily get to the clinic — which is 50 miles away.\u003c/p>\n\u003cfigure id=\"attachment_11942519\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg decoding=\"async\" loading=\"lazy\" class=\"wp-image-11942519 size-medium\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/03/Lammers_04-800x548.jpg\" alt=\"A middle-aged white woman with a long-sleeved shirt with horizontal blue-and-white stripes, with one shoulder pulled down to reveal a tattoo of an eye, looks at the camera as she leans against a door jamb. To her left, a white husky dog looks out from a window.\" width=\"800\" height=\"548\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2023/03/Lammers_04-800x548.jpg 800w, https://ww2.kqed.org/app/uploads/sites/10/2023/03/Lammers_04-1020x699.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/10/2023/03/Lammers_04-160x110.jpg 160w, https://ww2.kqed.org/app/uploads/sites/10/2023/03/Lammers_04-1536x1052.jpg 1536w, https://ww2.kqed.org/app/uploads/sites/10/2023/03/Lammers_04-2048x1402.jpg 2048w, https://ww2.kqed.org/app/uploads/sites/10/2023/03/Lammers_04-1920x1315.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Stephanie Lammers says the ride service provided by her Medi-Cal health plan is so bad that she stopped trying to use it about a year ago, after it left her in the lurch multiple times. 'I just don't go to the doctor anymore,' she says. \u003ccite>(Rich Pedroncelli/KHN)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>For Lammers, like many Medi-Cal enrollees who live in rural areas, lack of transportation is a major impediment to obtaining care. The problem is particularly acute for patients who need to see specialists.\u003c/p>\n\u003cp>Lammers’ dermatologist and eye doctor are over an hour away from San Andreas, the county seat of Calaveras County, about 125 miles northeast of San Francisco. She isn’t seeing a neurologist, despite a series of mini-strokes and stress-related seizures. And she hasn’t been to a podiatrist in two years, even though her toes are twisted over one another and hang down, causing her to trip. She’s often in excruciating pain when she walks.\u003c/p>\n\u003cp>Medi-Cal is supposed to provide \u003ca href=\"https://www.dhcs.ca.gov/services/medi-cal/Pages/Transportation.aspx\">free transportation to enrollees\u003c/a> who can’t otherwise get to their appointments.\u003c/p>\n\u003cp>But Lammers — whose health plan is California Health and Wellness, owned by Centene, \u003ca href=\"https://khn.org/news/article/centene-political-donations-medicaid-contracts-overbilling-allegations/\">the nation’s largest commercial Medicaid insurer\u003c/a> — stopped using its ride service nearly a year ago, after she missed dozens of appointments because drivers just didn’t show up, she said. She was getting threatening letters from doctors’ offices over the no-shows.\u003c/p>\n\u003cp>Once, she had to hitchhike more than 30 miles home from a counseling appointment. On other occasions, Lammers said, she did not receive the reimbursement she was owed for arranging her own rides.\u003c/p>\n\u003cp>“I just don’t go to the doctor anymore,” Lammers said. “If I go to the doctor, my boyfriend has to take the day off work, and if he takes the day off work, we have no money.”\u003c/p>\n\u003cp>During the last three months of 2022, Lammers canceled five appointments she had scheduled for the diagnostic abdominal procedures because her boyfriend had to work each time and couldn’t take her. She finally stopped rescheduling.\u003c/p>\n\u003cp>California Health and Wellness contracts with ModivCare, a Denver-based medical transportation company that is no stranger to \u003ca href=\"https://khn.org/news/article/medicaid-transportation-nonemergency-benefit-patients-stranded/\">patient complaints and lawsuits\u003c/a>.\u003c/p>\n\u003cp>Before she gave up on the ride service, Lammers said, she would call California Health and Wellness to try to resolve the issue, only to be told that ModivCare was a separate company. “I’m like, ‘If you guys hired them and put them in charge of transportation, who oversees their screwups?,’” she said.\u003c/p>\n\u003cfigure id=\"attachment_11942520\" class=\"wp-caption alignright\" style=\"max-width: 800px\">\u003cimg decoding=\"async\" loading=\"lazy\" class=\"wp-image-11942520 size-medium\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/03/Lammers_09-800x614.jpg\" alt=\"A white woman, standing in a crowded room of unmade beds, dishes potatoes onto a plate of biscuits and gravy from a hot plate on a cabinet next to a fridge. \" width=\"800\" height=\"614\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2023/03/Lammers_09-800x614.jpg 800w, https://ww2.kqed.org/app/uploads/sites/10/2023/03/Lammers_09-1020x783.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/10/2023/03/Lammers_09-160x123.jpg 160w, https://ww2.kqed.org/app/uploads/sites/10/2023/03/Lammers_09-1536x1180.jpg 1536w, https://ww2.kqed.org/app/uploads/sites/10/2023/03/Lammers_09-2048x1573.jpg 2048w, https://ww2.kqed.org/app/uploads/sites/10/2023/03/Lammers_09-1920x1475.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Stephanie Lammers has serious abdominal symptoms, and her gastroenterologist wants to run diagnostic tests, but she had to cancel five appointments in the last three months of 2022 because she didn't have transportation. \u003ccite>(Rich Pedroncelli/KHN)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Courtney Schwyzer, a member of a legal aid team representing Lammers on various Medi-Cal matters, said the failure of medical ride services is a systemic problem. In late February, Schwyzer and her fellow attorneys filed a petition in court that she hopes will force the state Department of Health Care Services to address the problem.\u003c/p>\n\u003cp>California Health and Wellness spokesperson Darrel Ng said the company monitors the quality of its contractors, but a shortage of transportation providers in rural areas “has created unique challenges.”\u003c/p>\n\u003cp>ModivCare provides more than 4 million rides for Medi-Cal recipients annually, and more than 99% are without complaint, said Melody Lai, a company spokesperson.\u003c/p>\n\u003cp>Lammers, who is unemployed and trying to start a custom craft business called Stuff by Steph, said doctors have warned her that if she doesn’t reduce her stress level, it could shorten her life. But arranging medical care is the most stressful thing in her life right now, so she doesn’t try anymore.\u003c/p>\n\u003cp>“In order to keep from dying, I have to not go to the doctor,” she said.\u003c/p>\n\u003ch2>'It's a blessing'\u003c/h2>\n\u003cp>Medi-Cal helped save the life of Carolina Morga Tapia, a 30-year-old full-time mother of five who lives with her family amid almond groves in an agricultural enclave of Fresno.\u003c/p>\n\u003cp>Nine years ago, a bacterial infection triggered premature labor during the 25th week of her second pregnancy, and Morga Tapia almost died. She spiked a fever, bled profusely and needed immediate transfusions and emergency surgery. After several days in critical care, she fully recovered.\u003c/p>\n\u003cfigure id=\"attachment_11942521\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg decoding=\"async\" loading=\"lazy\" class=\"wp-image-11942521 size-medium\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/03/carolina_tapia-2-800x534.jpg\" alt=\"A Latina woman with a blue cardigan and a black shirt looks at the camera, arms akimbo, standing in a leafless orchard.\" width=\"800\" height=\"534\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2023/03/carolina_tapia-2-800x534.jpg 800w, https://ww2.kqed.org/app/uploads/sites/10/2023/03/carolina_tapia-2-1020x681.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/10/2023/03/carolina_tapia-2-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/10/2023/03/carolina_tapia-2-1536x1025.jpg 1536w, https://ww2.kqed.org/app/uploads/sites/10/2023/03/carolina_tapia-2-2048x1367.jpg 2048w, https://ww2.kqed.org/app/uploads/sites/10/2023/03/carolina_tapia-2-1920x1281.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Carolina Morga Tapia stands amid almond trees outside her home in Fresno. She, her husband and their five children are enrolled in Medi-Cal, and she says she is very happy with the care it has provided, including emergency surgery that saved her life after she fell gravely ill during her second pregnancy. \u003ccite>(Heidi de Marco/KHN)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>But the doctors could not stop the premature birth, and her baby came out weighing just 1 pound. She and her husband, David Nuñez, named her Milagros Guadalupe, and she died four days later, on Sept. 13, 2013.\u003c/p>\n\u003cp>In each of her subsequent pregnancies, Medi-Cal paid for Morga Tapia to get shots of synthetic progesterone, intended to prevent another preterm birth. Those shots — one a week for about 20 weeks — can cost an average of \u003ca href=\"https://www.npr.org/sections/health-shots/2020/01/24/798731110/drug-to-prevent-premature-birth-divides-doctors-insurers-and-fda-experts\">more than $10,000 per pregnancy\u003c/a>.\u003c/p>\n\u003cp>Morga Tapia and Nuñez, a construction worker, signed up for Medi-Cal when she was pregnant with her first child more than a decade ago. They’ve been on the same Anthem Blue Cross Medi-Cal plan ever since.\u003c/p>\n\u003cp>The plan paid for prenatal care through all six of Morga Tapia’s pregnancies, and it has provided all the medical and dental care the family needs, she said.\u003c/p>\n\u003cp>“Without Medi-Cal, we would have to be paying for all of our children,” said Morga Tapia. “It saves a lot of money, and it’s a blessing to have that extra help.”\u003c/p>\n\u003cp>Her children, four girls and a boy, range in age from 1 to 10. They all go to the same children’s clinic and see the same pediatrician.\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"'Without Medi-Cal, we would have to be paying for all of our children. It saves a lot of money, and it's a blessing to have that extra help.'","name":"pullquote","attributes":{"named":{"align":"right","size":"medium","citation":"Carolina Morga Tapia","label":""},"numeric":[]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>The kids, all in good health, get routine checkups, vaccinations and other preventive care, Morga Tapia said. She gets appointment reminders via text and cards in the mail notifying her when it’s time for the kids’ vaccinations and wellness checks, as well as her Pap smears, she said.\u003c/p>\n\u003cp>Her family’s experience contrasts sharply with the state’s assessment of their health plan, according to a \u003ca href=\"https://www.dhcs.ca.gov/dataandstats/reports/Documents/Enhancing-Quality-for-Medi-Cal-Members.pdf\">report on quality of care in Medi-Cal issued late last year (PDF)\u003c/a>. The report, which evaluated Medi-Cal health plans on pediatric care, women’s health and chronic disease management, put Anthem Blue Cross in the lowest tier, and below par on multiple measures in numerous counties, including Fresno.\u003c/p>\n\u003cp>Another state report, released in late January, detailed how quickly insurers provide appointments for their patients, and put \u003ca href=\"https://www.dmhc.ca.gov/Portals/0/Docs/OPM/MY2021TAR.pdf\">Anthem Blue Cross’ Medi-Cal plan near the bottom of the heap (PDF)\u003c/a>.\u003c/p>\n\u003cp>Anthem Blue Cross spokesperson Michael Bowman said in a statement that the period covered in the reports coincide with the COVID-19 pandemic, “when our safety net providers dealt with significant challenges with workforce and appointment availability.”\u003c/p>\n\u003cp>Morga Tapia doesn’t give the insurer low marks. “It’s different for everybody. I have a good, healthy family, and what Medi-Cal covers is really fortunate for us,” she said.\u003c/p>\n\u003ch2>'I don't want to die yet'\u003c/h2>\n\u003cp>In late 2021, doctors gave Lucas Moreno Ramirez a few months to live.\u003c/p>\n\u003cp>Struggling with diabetes and late-stage lung cancer, Moreno Ramirez suffered debilitating pain as he hacked and labored for breath. His doctors recommended that he stop treatment and start hospice care.\u003c/p>\n\u003cp>He felt as if they were giving up on him.\u003c/p>\n\u003cp>“They said they’re going to give me opioids for my pain and help me have a comfortable death,” said Moreno Ramirez, 68, who lives in Norwalk, in Los Angeles County. “I told them I don’t believe in that. I don’t want to die yet.”\u003c/p>\n\u003cfigure id=\"attachment_11942525\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg decoding=\"async\" loading=\"lazy\" class=\"wp-image-11942525 size-medium\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/03/lucas_ramirez-3-800x534.jpg\" alt=\"A middle-aged Latino man, with a bushy gray mustache and thick gray hair combed back from his forehead, sits at a long table along a wall, on the other side of which a gauzy white curtain blows inward. He rests his right arm on the table, holding a blue-and-white mug. He looks at the camera, and is surrounded by cabinets with CDs, a massive water bottle, salt-and-pepper shakers, a clock on the wall and a nearby wind chime, and other homey detritus.\" width=\"800\" height=\"534\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2023/03/lucas_ramirez-3-800x534.jpg 800w, https://ww2.kqed.org/app/uploads/sites/10/2023/03/lucas_ramirez-3-1020x681.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/10/2023/03/lucas_ramirez-3-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/10/2023/03/lucas_ramirez-3-1536x1025.jpg 1536w, https://ww2.kqed.org/app/uploads/sites/10/2023/03/lucas_ramirez-3-2048x1367.jpg 2048w, https://ww2.kqed.org/app/uploads/sites/10/2023/03/lucas_ramirez-3-1920x1281.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Lucas Moreno Ramirez, a former landscaper and factory worker, has been diagnosed with both diabetes and lung cancer. Working alongside a care manager through his Medi-Cal managed-care plan, he has fought for better care and treatment for both conditions. \u003ccite>(Heidi de Marco/KHN)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>A former landscaper and factory worker, Moreno Ramirez learned he had to be his own advocate, fighting for the care he believed he deserved from Medi-Cal.\u003c/p>\n\u003cp>He said his Christian faith gave him strength, and over the next few months, he pushed the program and his doctors to keep battling his cancer, using a different treatment with fewer side effects than chemotherapy.\u003c/p>\n\u003cp>“I believe in prayer,” he said. “But I believe in science and medication, too.”\u003c/p>\n\u003cp>Moreno Ramirez is one of the \u003ca href=\"https://www.chcf.org/publication/in-alignment-calaims-plan-coordinate-care-dual-enrollees-medicare-medi-cal/\">roughly 1.6 million Californians enrolled in both Medicare, which covers people who are 65 and older or have disabilities, and Medi-Cal\u003c/a>, which \u003ca href=\"https://www.kff.org/medicare/issue-brief/a-profile-of-medicare-medicaid-enrollees-dual-eligibles/?utm_campaign=KFF-2023-Medicaid&utm_medium=email&_hsmi=243959452&_hsenc=p2ANqtz--_YdJIpoiPQ6BsTqKV7XWKRpOoR_sJTFFsZI7MrJWw-BvXTcEh0PRgAq42XpbIvOpISMXOG8GW_lDUH-w2IgL2Syf6YA&utm_content=243959452&utm_source=hs_email\">kicks in to cover the costs and benefits that Medicare doesn’t\u003c/a>.\u003c/p>\n\u003cp>He also relies on his Medi-Cal insurer to help him navigate the Byzantine system. L.A. Care, the largest Medi-Cal plan with nearly 2.6 million members, connected him with a care manager who worked with him to identify \u003ca href=\"https://www.cancer.gov/publications/dictionaries/cancer-terms/def/tagrisso\">a different treatment called Tagrisso\u003c/a> and advocated for him to get it.\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"aside","attributes":{"named":{"label":"Related Stories ","postid":"news_11940023,news_11941075,news_1981588"},"numeric":[]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>Even with the new medication, Moreno Ramirez’s coughing fits returned last year, and his symptoms grew so painful he suspected the cancer was growing. He asked to see his pulmonologist but was told the first appointment would be in June 2023. So he switched doctors and scored an appointment nearly six months sooner.\u003c/p>\n\u003cp>“My old doctor didn’t help me. I didn’t trust him,” Moreno Ramirez said. “He was always too busy for me. I told my doctors, ‘Give me a chance.’”\u003c/p>\n\u003cp>Having taken his care into his own hands, he says he’s not in pain, his cough has subsided and he feels hopeful for the future. “Now I feel good,” he said.\u003c/p>\n\u003cp>He has also sought more attention for his diabetes and received a continuous glucose monitor to measure his blood sugar. It’s better controlled now than it has been in decades, he said.\u003c/p>\n\u003cp>“You have to stand up for yourself and advocate,” said Joann Pacelo, the care manager who helped Moreno Ramirez change doctors, get quicker referrals to specialists and get approved for in-home nursing visits.\u003c/p>\n\u003cp>“A lot of times, it’s difficult with Medi-Cal because the doctors are busy and the reimbursements are so low, but no one should be denied the care they deserve.”\u003c/p>\n\u003cp>\u003cem>California Healthline is a service of the California Health Care Foundation produced by Kaiser Health News.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/news/11942493/californias-massive-medicaid-program-works-for-some-but-fails-many-others","authors":["byline_news_11942493"],"categories":["news_31795","news_457","news_8"],"tags":["news_18538","news_32481","news_32480","news_2605","news_20666","news_26763"],"affiliates":["news_20286"],"featImg":"news_11942528","label":"news_20286"}},"programsReducer":{"possible":{"id":"possible","title":"Possible","info":"Possible is hosted by entrepreneur Reid Hoffman and writer Aria Finger. Together in Possible, Hoffman and Finger lead enlightening discussions about building a brighter collective future. The show features interviews with visionary guests like Trevor Noah, Sam Altman and Janette Sadik-Khan. Possible paints an optimistic portrait of the world we can create through science, policy, business, art and our shared humanity. It asks: What if everything goes right for once? How can we get there? Each episode also includes a short fiction story generated by advanced AI GPT-4, serving as a thought-provoking springboard to speculate how humanity could leverage technology for good.","airtime":"SUN 2pm","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Possible-Podcast-Tile-360x360-1.jpg","officialWebsiteLink":"https://www.possible.fm/","meta":{"site":"news","source":"Possible"},"link":"/radio/program/possible","subscribe":{"apple":"https://podcasts.apple.com/us/podcast/possible/id1677184070","spotify":"https://open.spotify.com/show/730YpdUSNlMyPQwNnyjp4k"}},"1a":{"id":"1a","title":"1A","info":"1A is home to the national conversation. 1A brings on great guests and frames the best debate in ways that make you think, share and engage.","airtime":"MON-THU 11pm-12am","imageSrc":"https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/1a.jpg","officialWebsiteLink":"https://the1a.org/","meta":{"site":"news","source":"npr"},"link":"/radio/program/1a","subscribe":{"npr":"https://rpb3r.app.goo.gl/RBrW","apple":"https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?s=143441&mt=2&id=1188724250&at=11l79Y&ct=nprdirectory","tuneIn":"https://tunein.com/radio/1A-p947376/","rss":"https://feeds.npr.org/510316/podcast.xml"}},"all-things-considered":{"id":"all-things-considered","title":"All Things Considered","info":"Every weekday, \u003cem>All Things Considered\u003c/em> hosts Robert Siegel, Audie Cornish, Ari Shapiro, and Kelly McEvers present the program's trademark mix of news, interviews, commentaries, reviews, and offbeat features. Michel Martin hosts on the weekends.","airtime":"MON-FRI 1pm-2pm, 4:30pm-6:30pm\u003cbr />SAT-SUN 5pm-6pm","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/All-Things-Considered-Podcast-Tile-360x360-1.jpg","officialWebsiteLink":"https://www.npr.org/programs/all-things-considered/","meta":{"site":"news","source":"npr"},"link":"/radio/program/all-things-considered"},"american-suburb-podcast":{"id":"american-suburb-podcast","title":"American Suburb: The Podcast","tagline":"The flip side of gentrification, told through one town","info":"Gentrification is changing cities across America, forcing people from neighborhoods they have long called home. Call them the displaced. Now those priced out of the Bay Area are looking for a better life in an unlikely place. American Suburb follows this migration to one California town along the Delta, 45 miles from San Francisco. 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You can also visit the MindShift website for episodes and supplemental blog posts or tweet us \u003ca href=\"https://twitter.com/MindShiftKQED\">@MindShiftKQED\u003c/a> or visit us at \u003ca href=\"/mindshift\">MindShift.KQED.org\u003c/a>","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Mindshift-Podcast-Tile-703x703-1.jpg","imageAlt":"KQED MindShift: How We Will Learn","officialWebsiteLink":"/mindshift/","meta":{"site":"news","source":"kqed","order":"2"},"link":"/podcasts/mindshift","subscribe":{"apple":"https://podcasts.apple.com/us/podcast/mindshift-podcast/id1078765985","google":"https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkM1NzY0NjAwNDI5","npr":"https://www.npr.org/podcasts/464615685/mind-shift-podcast","stitcher":"https://www.stitcher.com/podcast/kqed/stories-teachers-share","spotify":"https://open.spotify.com/show/0MxSpNYZKNprFLCl7eEtyx"}},"morning-edition":{"id":"morning-edition","title":"Morning Edition","info":"\u003cem>Morning Edition\u003c/em> takes listeners around the country and the world with multi-faceted stories and commentaries every weekday. 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On Our Watch brings listeners into the rooms where officers are questioned and witnesses are interrogated to find out who this system is really protecting. Is it the officers, or the public they've sworn to serve?","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/On-Our-Watch-Podcast-Tile-703x703-1.jpg","imageAlt":"On Our Watch from NPR and KQED","officialWebsiteLink":"/podcasts/onourwatch","meta":{"site":"news","source":"kqed","order":"1"},"link":"/podcasts/onourwatch","subscribe":{"apple":"https://podcasts.apple.com/podcast/id1567098962","google":"https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5ucHIub3JnLzUxMDM2MC9wb2RjYXN0LnhtbD9zYz1nb29nbGVwb2RjYXN0cw","npr":"https://rpb3r.app.goo.gl/onourwatch","spotify":"https://open.spotify.com/show/0OLWoyizopu6tY1XiuX70x","tuneIn":"https://tunein.com/radio/On-Our-Watch-p1436229/","stitcher":"https://www.stitcher.com/show/on-our-watch","rss":"https://feeds.npr.org/510360/podcast.xml"}},"on-the-media":{"id":"on-the-media","title":"On The Media","info":"Our weekly podcast explores how the media 'sausage' is made, casts an incisive eye on fluctuations in the marketplace of ideas, and examines threats to the freedom of information and expression in America and abroad. 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