Up To 2.8 Million Californians To Lose Medi-Cal Coverage Over Income Verifications

The California Medical Assistance Program (Medi-Cal) is expected to lose between 1.8 million and 2.8 million of their roughly 15 million enrollees by the end of 2024, according to a new report released on Monday, with verifications resuming this week already removing thousands across the state since the beginning of July.

Before the COVID-19 pandemic in early 2020, eligibility was determined by many factors. While most factors, including age, having a disability, and pregnancy remained unchanged after pandemic laws came into place, one did change: income verification. Due to a quick rise in unemployment and layoffs in March and April 2020 with so many businesses shut down by COVID-19, as well as the Employment Development Department (EDD) being swamped by new claims, Medi-Cal suspended the income verification requirement to keep as many people as possible on health insurance.

The income requirement, which is set at 138% below the poverty level, or for one person making $20,121 or less a year, was subsequently removed, bringing in a wave of new people onto Medi-Cal. While Medi-Cal’s roll had already been growing in the late 2010’s, thanks to new expansions such as allowing people in regardless of immigration status, the COVID bump of enrollees brought the total number of people on it by millions.

For the last several years, the income verification requirement was not reinstated, largely due to lingering COVID-19 concerns and Medicaid protections instilled by the U.S. Congress keeping those protections for three years. However, the Medicaid protections were not renewed, allowing states to finally reinstall the income verification requirements. Nationally, 15 million are expected to go off of Medicaid by the end of next year. In California, the state hasn’t contested removing the Medi-Cal protections either, leading to Medi-Cal being responsible for between 1.8 million to 2.8 million leaving Medicaid/Medi-Cal, by far the largest state according to the federal estimate.

Statewide, tens of thousands have already been removed from Medi-Cal rolls since the beginning of the month. Locally, public health plans such as L.A. Care have already seen major losses as well, with many worried about just how many people will be removed from Medi-Cal as a result.

“The verification process is going to be very bumpy,” noted L.A. Care Health Plan chief executive John Baackes on Monday. “Six thousand L.A. Care customers have lost their Medi-Cal coverage since California began the process, and that number is expected to increase to 350,000 by the end of 2024.”

Medi-Cal Age verification resumes

However, others have said that the system is simply realigning itself and removing many people who simply don’t qualify anymore as a result.

“A lot of people who have been removed, both in California and nationally, just don’t need coverage anymore,” explained Cindy Showalter, a Los Angeles-based Medicare advisor for people aged 65 or older, to the Globe on Monday. “Remember, this is just based on income too. Kids aren’t being removed people above 65 aren’t being removed, those with disabilities aren’t being removed. What we have been seeing are mostly people who have jobs now and can afford healthcare or have access to paid state or private healthcare being removed. Or people who make above the minimum amount now.”

“Medicare, and Medi-Cal, it is supposed to be a safety net, and one you only get if you pay into. During COVID, every government agency was swamped and no one wanted people to miss the net so to speak. But now, with things clearing up, we need to make sure that everyone on it is eligible. That’s all this is. It’s correcting. The trouble is, as we’ve seen, there were just so many who stayed on now who don’t need it that it will take over a year to go through it. We’re going back to ‘If you need it and paid in, you can get it’. The COVID emergency is long over.”

“But we also need to do this right and make sure no one falls through the cracks either, which is why it is taking so much time.”

The resumed Medi-Cal verifications are expected to continue removed COVID-protected Californians off the roll until at least the end of 2024.