Last Updated on October 12, 2023 by BVN
Breanna Reeves
With more than 15 million beneficiaries at risk of being disenrolled for Medi-Cal benefits, the Department of Health Care Services (DHCS) released their first month of redetermination data.
DHCS recently launched the Medi-Cal Continuous Coverage Unwinding Dashboard with data from June, the first month for which redetermination data is available. The interactive dashboard will be updated monthly as the department continues to review eligibility in what will be a process lasting until May 2024.
California has begun the process of redetermining eligibility for millions of members, the most of any state in the country. In the first month of redeterminations or “unwinding,” California has disenrolled 21% of Medi-Cal members, according to Assistant Deputy Director of Health Care Benefits and Eligibility at DHCS Yingjia Huang during an Ethnic Media Services press briefing on Aug. 15.
Residents of Color experiencing highest rates of disenrollment
More than 225,000 residents have been disenrolled from Medi-Cal due to several challenges such as not returning Medi-Cal renewal packets that were mailed out in yellow envelopes, not receiving their mail due to a change of address, as well as some residents are no longer eligible for Medi-Cal benefits, according to Huang. This figure also includes some residents who chose not to renew their coverage.
Of those who have lost their Medi-Cal benefits under the redetermination process, residents of colors make up the majority. Approximately 53% of beneficiaries (117,849 ) who identify as Hispanic have been disenrolled from Medi-Cal so far, the most of any other racial/ethnic population. Comparatively, 6% of Black beneficiaries (13,278), 16% of white beneficiaries (36,136) and 8.7% of “other” ethnicities (19,276) have been disenrolled.
“For Latinos, we are still recovering — Latinos and other communities of color, we are still recovering from a devastating pandemic,” Dr. Seciah Aquino, executive director for the Latino Coalition for a Healthy California (LCHC), said during the briefing. “So, our health, our economies are very fragile. Medi-Cal actually provides a way to safety, a way to opportunity and a way to recovery.”
California Department of Public Health data showed that Latinos in California account for 36% of the state’s population, but made up 42% of COVID deaths, totalling more than 42,000 since the start of the pandemic.
Dr. Aquino explained that the responsibility to maintain coverage for the Latino communities and communities of color is “on us” — community partners, trusted messengers and state agencies.
Regaining coverage, new enrollments and Covered California
Medi-Cal members have 90 days — through September 30 — after they have been disenrolled to take measures to restore their coverage by providing necessary or missing information to their local Medi-Cal office.
At the same time that DHCS is redetermining Medi-Cal eligibility, they are also processing new enrollments. The department has received approximately 143,000 applications as of June 2023.
Members who are found to be no longer eligible for Medi-Cal can transition to Covered California, the state’s low cost health care coverage marketplace. So far, Covered California has received 33,399 new applications through the redetermination process, according to the DHCS data dashboard.
“Most Californians who lose Medi-Cal coverage, but qualify for Covered California will be able to get coverage at either no or low cost each month,” said Covered California’s Executive Director Jessica Altman. “In fact, early data shows about a third of those coming over from Medi-Cal are finding $0 monthly premiums on Covered California.”
According to Altman, nearly 90% of Covered California’s enrollees receive financial help and two-thirds are eligible to pay $10 or less per month for their health insurance.
In an effort to increase health care affordability and access, beginning on Jan. 1, 2024, Covered California will eliminate deductibles entirely for over 650,000 of those who will be enrolled and anyone who makes up to 250 percent of the federal poverty level covered through Covered California. Those eligible under this criteria include individuals that earn as much as $33,975 annually and families that earn up to $69,375 annually.
As DHCS continues the process of redetermination, they have assembled an awareness campaign that aims to inform beneficiaries of the unwinding process and remind them to update their personal information with the county and to check their mail.
For June, more than 81% of the redeterminations due returned their renewal packet for county offices or who were renewed through other verification processes.
This article is published as part of the Commonwealth Health Equity Reporting Fellowship.