California Health Report: New Medi-Cal Renewal Process Could Lead to Loss of Coverage, Advocates Say

Heather Lore of Ojai, who recently received a Medi-Cal renewal package, said she had to fill out separate forms for herself and her sons, Jedi (left) and Dragon, which she found redundant and confusing.

By Claudia Boyd-Barrett

New enrollment forms the Medi-Cal program is using because of changes brought about by federal health reform are so confusing that they could lead to tens of thousands of eligible recipients losing their benefits, say advocates for the poor.

County officials say the new format will ultimately make it easier for recipients to remain eligible from one year to the next. But critics say the forms ask for detailed information about income and tax deductions that many recipients might not understand or have at their disposal. To make matters worse, the forms are currently available only in English and Spanish, leaving many recipients unable even to read them.

“We are very concerned,” said Shirley Sanematsu, senior health attorney with the Western Center on Law and Poverty “We just don’t see how this is going to be tenable.”

New rules under the federal Affordable Care Act have expanded Medi-Cal and changed how eligibility for the program is determined. As a result, the state has had to change the forms that counties send out each year to people already enrolled in the program to see if they are still eligible.

As a beneficiary of the program for six years, Johnnie Sanders thought she had mastered how to fill out the annual form to renew her Medi-Cal coverage.

But when the 71-year-old from Carson received her renewal package in the mail recently, she discovered that the forms were unrecognizable.

“They were so complicated,” said Sanders, who is disabled and cannot work. “It used to be every year they were pretty much the same.

“This time they sent them out it’s totally different. The first part of the application wanted you to put down your employer, where you worked. It was different, very confusing.”

Counties began mailing the first batch of new redetermination forms to beneficiaries in April. These forms are due by the end of June — but the state will likely be unable to process them until July, according to Gov. Jerry Brown’s revised state budget released May 13. The state is first trying to reduce a backlog of 900,000 new Medi-Cal applications, due in part to the fact that officials prioritized the open-exchange enrollment softwareover Medi-Cal’s.

Medi-Cal recipients will…

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