Californians are encountering unexpected challenges with their Medi-Cal insurance coverage, with stories emerging of individuals like Florinda Miguel, who discovered her coverage had lapsed when she took her daughter for a routine dentist appointment in early December. Despite not receiving renewal notices or paperwork, Miguel’s Medi-Cal had expired, requiring her to postpone her daughter’s dental visit until the coverage was reinstated.
In response to the COVID-19 pandemic, states, including California, resumed eligibility reviews for low-income individuals enrolled in Medicaid (Medi-Cal in California) this spring after a pause in 2020. Now, six months into the renewed process, thousands of Californians are discovering the loss of coverage due to issues with missing or incomplete paperwork. State data indicates that over 928,000 people had their Medi-Cal terminated between June and October, with nearly 90% losing coverage due to procedural reasons, often related to paperwork problems.
The termination rate linked to procedural issues in California ranks fourth nationally, according to the Kaiser Family Foundation. Among those due for Medi-Cal renewals, 47% retained coverage, 15% faced paperwork-related removal, 2% no longer qualified, and 35% are still under review.
Advocates highlight various reasons for coverage losses, including individuals being unprepared or unaware of the renewal process. The sudden transition from the pandemic message of “ignore, ignore, don’t worry” to a renewed verification process caught many off guard. Some disenrolled individuals may have alternative health insurance through employers or may have moved without updating their address with the county Medi-Cal office, missing renewal alerts.
Health advocates emphasize challenges faced by those seeking assistance, including long wait times when contacting county Medi-Cal offices and limited support from organizations. Gaps in support contribute to delays in care, missed medications, and out-of-pocket costs for families. Efforts are underway to streamline the renewal process, with the state working to increase automatic renewals using electronic databases to verify income and eligibility. However, advocates stress the need for improved support services to help individuals navigate the paperwork and maintain their coverage.
This report is supported by the California Health Care Foundation (CHCF), which aims to ensure people have access to affordable care when needed. Visit www.chcf.org for more information.