Paperwork Change Could Push Kids off Medi-Cal

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(Sacramento, CA)
Wednesday, September 24, 2008

Consumer advocate Anthony Wright of California Health Access calls the new policy a cynical cut. 

“This is a back door way of fairly dramatically reducing the number of children with Medi-Cal coverage.” 
Wright says kids will be dropped off of Medi-Cal because families will have to send in status reports twice a year instead of once. Each report includes information like income, address changes and number of people in the family.  It may sound simple, but Wright says about a quarter million children will lose health coverage because of the additional report.

“This confirms some of the worst conspiracy theories that people have about government that in fact there’s some paperwork there that is meant to keep them away from the coverage or service that they’re entitled to.” 

Cover the Kids is a Sacramento based group that connects low-income families with health insurance. Carmen Herrera says the parents she helps move around a lot and are sometimes illiterate. She says their circumstances can make it difficult for them to fill out the paperwork.

“We’ve seen where families don’t have employment, when there’s other changes in the family, that’s going to be put maybe on the back burner.”
Herrera points to Manuel Martin as an example. Martin lives in Galt and has three daughters on Medi-Cal. He says in order to stay in the program he has to report his income and assets down to the dollar. Herrera translates for Martin.

“He compared it to filing taxes where it is complicated to file your own taxes and this is yearly so to him it’s like the same thing when you renew your Medi-Cal for your children but now having to do that twice a year would be a lot more complicated.”

Martin says the additional report may just be too much – he might have to give up his daughters’ health care coverage.  

Herrera translates for Martin: “If they have to renew every six months he probably will let it cancel on it’s own without renewing.”

But state officials insist situations like Martin’s would be the exception, not the rule.  California Chief Deputy Director of Health Care Services Stan Rosenstein says eligible kids won’t be dropped and the extra paperwork is easy.

“There’s all sorts of checks and balances to make sure children don’t lose coverage who aren’t ineligible and again it’s a simple form just a check a box sign your name, mail a postage-paid return envelope.” 
Rosenstein estimates about 30,000 children per month will lose Medi-Cal this year and up to 200,000 per month next year because of the reporting change. But he can’t say whether all of those kids will actually be ineligible. Ultimately, Rosenstein says California will save about $115 million over the next two years with the new policy.

“It’s a minimal amount of effort for a very important and expensive benefit under Medi-Cal.”
The Kaiser Family Foundation tracks Medicaid enrollment policies around the country. It found only six other states require twice yearly reporting. And according to the foundation, more paperwork results in significant drops in enrollment. The state says it won’t know the full impact for families until next year when it reviews the numbers. But, critics of the new policy say that will be too late for sick, eligible children who will have lost their coverage.