KPCC: Snafu keeps thousands of low-income Angelenos out of Medi-Cal

Adrian Florido

Pay raise for Inland Empire doctors

Photo by Alex Proimos via Flickr Creative Commons

Several thousand low-income people who were supposed to be switched on January 1st from an L.A. County health plan to Medi-Cal have fallen through the bureaucratic cracks. The county blames differences in personal information kept by the county and the state, and says it has corrected about half of the cases in question.

In the run-up to the Affordable Care Act’s Medicaid expansion, L.A. County received federal funding to get low-income people covered early. Beginning in 2011, it signed more than 300,000 people up for coverage under a program called Healthy Way L.A.

The idea was that once those people became eligible for Medi-Cal on January 1st, 2014,Healthy Way L.A. would end and the county would transition those people onto Medi-Cal.

For most of the participants in the program, the transition went smoothly. But for about 5,000 of them, it didn’t happen, according to the county. Instead, they lost coverage, and for some, that has had serious consequences.

One of them is Yolanda Garate, a diabetic who was not transferred to Medi-Cal on January 1, said her husband, Juan Garate.

“She had a doctor’s appointment but they wouldn’t see her because she didn’t have Medi-Cal,” he said. “So she couldn’t get her prescription” for insulin.

Garate said his wife went more than three months without her insulin, causing her health to steadily deteriorate.

Finally, about two weeks ago, an employee at the Garate’s clinic, the Eisner Pediatric and Family Medical Center in downtown L.A., called the county and said Yolanda’s case was urgent. A county worker pulled her record and was able to get her Medi-Cal approved, so she finally got her insulin. 

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