Medi-Cal income restrictions at 30 keep some seniors out of intensive care

A doctor with a Medicare patient.Photo courtesy of the Centers for Medicare and Medicaid Services
A doctor with a Medicare patient.Photo courtesy of the Centers for Medicare and Medicaid Services

Life in California is expensive. So imagine having to live on $600 a month. This is basically what some seniors and people with disabilities have to do in order to get Medi-Cal, the health insurance program for California’s low-income residents.

Individuals with substantial medical bills – but incomes too high to Eligible for Free Medi-Cal – If they pay some fees, they can still access the program.

This part of the cost is like a monthly deductible; people are allowed to keep $600 for personal use and must spend the rest of their income on health care expenses before their Medi-Cal coverage begins.

“If you make $1,600 a month, you have to have $1,000 to pay for your care,” said Tiffany Huyenh-Cho, a staff attorney with Justice for Aging, a group that is urging state lawmakers to update income rules. Because people using this type of Medi-Cal often require expensive care, it’s worth paying for for some but unaffordable for most, she said.

January this year, last month What status data is available, about 81,000 people took Medi-Cal but couldn’t use it because they didn’t pay their share. Data shows that most are over 65 or disabled.

Take Maxine Wells of San Diego—she’s 91 and recently applied for Medi-Cal with the help of her son Keith Wells. Her Social Security monthly income is $2,000, which is over the limit for free coverage. Keith is still waiting for an official word from the state government on his mom’s eligibility status, but isn’t sure if they’ll be able to pay her share.

The dollar amount people can keep, $600 for individuals and $934 for couples, has not changed since 1989, when Minimum wage is $4.25 One hour.

“It’s shocking to hear that it hasn’t been updated since then,” Keith Wells said.

Seniors like Wells are also eligible for Medicare, the federal health insurance program for seniors and people with disabilities. But health insurance didn’t cover all of her needs or home care. Wells, a former beauty shop owner, suffered a heart attack that damaged her heart muscle. She suffers from chronic obstructive pulmonary disease, dementia and anxiety. Medi-Cal will supplement her Medicare coverage. about 1.4 million Californians participated in both projects.

California rolled out the nation’s first comprehensive policy to expand health insurance coverage to more people. It has one of the lowest uninsured rates in the country — About 6% of California residents No health insurance. Still, a small percentage of people continue to struggle to afford the insurance and care they need, meaning they are uninsured.

Ageing advocates say older people tend to live on fixed incomes but are sometimes bound by rules that don’t match the current cost of living.

Aging and Health Advocates are asking now Legislators and the governor’s office are allowing Medi-Cal recipients who pay a portion of the fee to keep more of their income. Act of Parliament 1900 Dr. Joaquin Arambula, Democrat of Fresno, proposed raising the monthly limit for individuals from $600, or about 55 percent of the federal poverty level, to $1,562, or 138 percent of the federal poverty level.

The adjustment requires federal approval, according to the Department of Health Care Services, which oversees the Medi-Cal program.

Alhambra’s bill passed parliament last week and is now in the Senate. “It’s just a matter of fairness for Californians who are struggling to make ends meet and need access to health care,” Alhambra said of his bill at a parliamentary health committee hearing earlier this year.

Linda Nguy, a policy advocate with the Western Center for Law and Poverty, said it would be difficult to pass the bill if funding for the bill is not included in this year’s state budget. Funding for the proposal was not included in the governor’s May budget revision.

However, a version of the budget released Wednesday by Democratic leaders of the legislature allocated $31 million to reduce this population’s share of the cost. The Legislature and Gov. Gavin Newsom must now come together to hammer out the final budget.

The Office of the Legislative Analyst has estimate this proposal It will cost between $53 million and $151 million, with half being paid for by state governments and the other half by federal funds. Without the funding, Nguy said, Arambula’s bill could find its way into the Senate’s finance committee.

At least nine other states and the District of Columbia allow people who pay a portion of Medi-Cal (Medicaid in other states) to keep a higher amount for personal use than California does, According to the Kaiser Family Foundation.

“It’s so unfair,” said Naty Chavira, a Los Angeles-area teacher whose parents, Jose and Alicia Chavira, are struggling to afford expensive drugs and family assistance. “You know how hard my dad is? He paid his taxes, he’s a good citizen, and today he’s in survival mode. I know his finances are taking a toll on his health.”

Jose, 77, a former welder, has been battling a number of health problems and symptoms – diabetes, depression and vertigo, to name a few. He spent most of his retirement caring for his wife, Alicia, 78, a former homemaker of six children who was diagnosed with Alzheimer’s a few years ago. But now his health is also deteriorating.

Naty wanted her parents to get some family assistance and her father to get the hearing aids he needed, but Medicare wouldn’t pay for them, so she helped them apply for Medi-Cal. To get this coverage, however, the couple will only be able to keep $934 of their monthly Social Security income of $2,600.

When you take the $500 bill, they can keep the $400 in food and medicine. “It’s crazy,” Chavira said.

California Affairs is a nonprofit journalism enterprise dedicated to explaining how the California State Capitol works and why it matters.

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