Medi-Cal Outreach Gets Big Boost

If the state won’t pay for it, one private donor will. The California Endowment yesterday committed $26.5 million to fund the state’s Medi-Cal expansion outreach under the Affordable Care Act.

The Assembly Budget Subcommittee on Human Services yesterday voted unanimously 3-0 to accept the contribution and directed state officials to apply for federal matching funds for a total of $53 million in outreach money.

“The success or failure of Obamacare will depend on how many will enroll,” said Daniel Zingale, senior vice president for the Endowment. “In this state, it’s enormously challenging. … We have more uninsured here than many other states have people.”

The state’s health benefit exchange, Covered California, has committed $43 million to its outreach effort, but under federal guidelines, that exchange money can only be spent on enrollment efforts to sign people up for the exchange.

That leaves about one million Californians who are eligible for Medi-Cal and not receiving it, and another 1.4 million people who will become eligible under optional Medi-Cal expansion to 133% of federal poverty level. The state has said it wouldn’t fund outreach to that population, prompting the Endowment to step in with its contribution.

Reaching all of those people, Zingale said, given the barriers of low-income lifestyles and multiple languages spoken, is going to take a Herculean effort.

With open enrollment starting in October, that effort needs to start soon, Zingale said. Advertising and other outreach efforts need to be in place this summer. Complicated messaging campaigns take time and have to be worked out now, he said. Zingale said the debate between the state and counties on how to divide $1.4 billion in health care relief the counties are expected to receive from Medi-Cal expansion is an obstacle. The longer that discussion goes on, he said, the longer it will take to make expansion official, and start any outreach efforts.

“Just take a lesson from Hollywood, the masters of marketing,” Zingale said. “They start selling a film a year in advance. If you start marketing on opening day, you’re looking at a box office bomb.”

Outreach money will be support successful Medi-Cal applications of the navigator/assistor enrollment program as well as the state’s Community Based Organization grants program for Medi-Cal outreach and enrollment, which targets vulnerable populations.

Zingale said the key to realizing the promise of the Affordable Care Act is  

shifting the cost and quality of care to provide it earlier —  in preventive rather than emergency services.

“The most important thing for people to understand is the return on these investments,” Zingale said. “The opportunity Obamacare offers us is to prevent more costly illnesses, to save both lives and money and … to get healthy people into the [health insurance] mix, to help contain costs for all of us.”

The money spent on outreach could get more people into the insurance pool and help fulfill the promise of health care reform, he said.

“A lot of the people we’re talking about enrolling are healthy people,” Zingale said, “because overall, that makes for a better mix.”

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Capitol Desk Medi-Cal