Medi-Cal barriers removed
California’s undocumented poor in the 26 to 49-year demographic who have no access to primary care, will receive a respite, reported the Sacramento Bee, from California’s proposed Medi-Cal expansion, due to launch on January 1st, 2024. Working families in this particular age group are still excluded from the program because of immigration status. Those who cannot afford primary medical care face financial ruin if the health of a family member worsens. However, starting in January, they can now enroll in Medi-Cal, regardless of immigration status.
Barriers to care have already been removed for children, young adults, and seniors age 50 and over.
Consistent levels of care
At a November 15 briefing co-hosted by Ethnic Media Services and the Department of Health Care Services, experts shared information on the expansion and the challenges ahead.
“Expanding the full-scope Medi-Cal means all low-income Californians have access to primary care doctors,” said Michelle Retke, DHCS Chief of Managed Care Operations. That’s critical, especially for those with a condition that could get significantly worse over time if it is not monitored or treated. Having access to a regular doctor and having regular checkups would enable them to receive a more consistent level of care.
For many of the 21 counties, managed care — which uses health insurance plans, like Kaiser or Anthem, to provide primary care doctors picked from a network of local health centers — is transitioning to a single-plan model where previously multiple plans were offered, Retke explained. For other affected counties, different plans will replace those currently there.
“In October, November, and December, Medi-Cal members will get a notice that their plan is changing, and an enrollment choice packet that they can fill out on paper or online.”
Participation in re-certification of eligibility for Medi-Cal
Starting January 1, 2024, 21 counties in California will transition to new managed care plans. Retke’s advice to Medi-Cal members in these counties is clear: pay attention to your mail for notifications about changes in plans. Yingjia Huang, Assistant Deputy Director of Health Care Benefits and Eligibility at DHCS, emphasized the importance of the Medi-Cal redetermination process to avoid being disenrolled from Medi-Cal plans.
Participating in the recertification process of eligibility for Med-Cal is critical for enrollees to continue to get care. California faces a colossal task, reviewing the eligibility of 15 million Medi-Cal enrollees, in the post-COVID era. Two to three million Californians face potential disenrollment if they don’t participate in recertification warned Huang. She urged enrollees to be vigilant about communication from local Medi-Cal offices and immediately respond to notifications by filling out and returning Medi-Cal renewal packets and enrollment choice packets. Not doing so risks disenrollment and losing care altogether.
Hurdles to care
Many Californians who are eligible for Medi-Cal and Covered California aren’t aware of their Medi-Cal benefits or face enrollment hurdles that serve as barriers to coverage.
“Institutional barriers, perceptual barriers and structural barriers mean these populations are hardly reached,” said Dr. Sergio Aguilar-Gaxiola, Professor of Internal Medicine, UC Davis. So many undocumented farm workers may not take advantage of the expansion of Medi-Cal benefits .
Aguilar-Gaxiola, who also is Director, UC Davis Center for Reducing Health Disparities (CRHD), referred to the results of a Fresno County study of access to services for mental disorders, which found that 50% of respondents didn’t know where to go for the services and almost 50% had no way to pay.
“Just, just think about it, didn’t know where to go for the services! Almost 50%!! It would be imperative to reach out to farmworkers,” he added, “where they live, where they work, where they congregate and to do it outside of the working hours including weekends”
Language barriers to care
There are approximately 600,000 to 700,000 farmworkers in California, said Aguilar-Gaxiola, with 900,000 dependents — a total of 1.5 million. Forty percent of them are undocumented. Fifty percent of them have less than 8 years of schooling and two-thirds speak little or no English. Medi_Cal must consider this when it disseminates information about the expansion.
The onus is on us, said Dr. Sergio Aguilar-Gaxiola, to make sure they know of the help available to them and they enroll promptly. This forward-thinking initiative, despite its challenges, is a beacon of hope and a model for other states to follow in ensuring healthcare for all.
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