California began redetermining Medi-Cal eligibility of members in April, and has since disenrolled 225,231 individuals, while 499,093 individuals have maintained their Medi-Cal coverage, according to Yingjia Huang, assistant deputy director of Health Care Benefits and Eligibility at the Department of Health Care Services (DHCS).
This week, Huang hosted a webinar with stakeholders to go over Medi-Cal unwinding information, and shared the state’s interactive dashboard to explain June data.
“We are facing one of the most significant opportunities since the Affordable Care Act when it comes to coverage retention of our members.”
— Huang
The diversity and volume of individuals in California make Medi-Cal redeterminations an extraordinary task for all involved, Huang said, adding that over 15 million Californians will undergo the process. DHCS began preparing for the unwinding several years ago when the federal public health emergency was put in place because they were unsure of when the emergency order would end.
The data on DHCS’s dashboard helps the department develop strategies and investments for supporting the Medi-Cal population, and helps the department decide whether it needs to alter messaging to members.
“This is the first time the department has ever posted something so early, which is 45 days after the actual last day of the coverage month of June,” Huang said, adding that DHCS usually reports data 90 days after June, or in October. “This is in the spirit of full transparency in the unwinding journey.”
Total Medi-Cal enrollment for June was 15,568,357 individuals statewide, with the first set of disenrollments taking place on July 1st. While the state continues to conduct redeterminations, individuals are continuing to sign up for coverage. In June, DHCS received 143,069 applications in total, 125,145 of which were determined to be eligible for Medi-Cal coverage or the Children’s Health Insurance Program.
Of the new applications received, 33,399 were submitted through Covered California while 109,670 were submitted via county application pathways, such as in person, through the mail, or through the phone.
“Each month will be a learning moment for the department. The month of June was the first month. Our numbers are actually … what we [would] call ‘good.’”
— Huang
A total of 1,051,401 individuals underwent redeterminations in the month of June, out of which:
- 281,103 were renewed ex-parte, or without additional information needed from members
- 217,990 continued with Medi-Cal
- 225,231 were discontinued
- 327,077 are in process
For the group whose redeterminations remain in process, their Medi-Cal also remains active until there is a set outcome. Out of the 499,093 individuals who maintained Medi-Cal coverage, the majority were above the age of 22 years and almost half identified as Hispanic.
After the last day of Medi-Cal coverage, individuals have 90 days to regain coverage if requested information from the state is returned. The Western Center on Law and Poverty told State of Reform that an unacceptably large number of individuals are suffering from Medi-Cal coverage cut-offs due to paperwork-related reasons, such as not speaking the threshold languages in which information packets are sent out in, or not having enough time in between work to complete the renewals.
Written languages of those who were discontinued in June include:
- 64.23 percent English
- 31.93 percent Spanish
- 2.27 percent additional written languages
- 0.89 percent Vietnamese
- 0.68 percent with language unknown
Of the total disenrollments so far, 199,763 were discontinued for procedural reasons, such as not speaking any of the threshold languages; 2,572 were due to exceeding the income requirements; and 22,891 for other reasons, including having moved out of the state. The Western Center on Law and Poverty proposed that California pause redeterminations due to the procedural drivers of disenrollment, similar to Minnesota and other states.
Huang said that if individuals provide the necessary information to the state within 90 days after they lost coverage, their coverage will be restored with no gap. DHCS is ramping up outreach strategies, such as providing a list of procedural terminations to health enrollment navigators on a monthly basis, who will provide specific outreach to those individuals.