Advocacy Groups Sue DHCS Over Medi-Cal Coverage Cancellations

On Monday, a coalition of advocacy groups filed a lawsuit against the California Department of Health Care Services alleging that state residents are being wrongfully dropped from Medi-Cal, the state's Medicaid program, Kaiser Health News reports (Gold, Kaiser Health News, 11/18)

Background

About 2.7 million additional Californians signed up for Medi-Cal under the Affordable Care Act's expansion of the program. A total of about 11.3 million state residents now are covered by the program (Gorn, California Healthline, 11/12).

Under the expansion, previously enrolled residents had to reapply under Medi-Cal's new eligibility standards. In addition, all enrollees are required to renew their coverage annually. However, the renewal forms this year requested new information, compared with previous years, according to KHN.

As a result, a higher number of Medi-Cal enrollees have not submitted their renewal forms, officials report. Specifically, DHCS Director Toby Douglas said up to 50% of the Medi-Cal population in some counties has not renewed coverage, compared with about 20% to 40% in past years.

Some advocates say at least one million people could be cut from Medi-Cal as a result of low renewal rates.

Details of Lawsuit

The lawsuit was filed by the Western Center on Law & Poverty, among other groups. It alleges that Medi-Cal enrollees have not been properly notified that they must renew their coverage.

Jen Flory -- a senior attorney at WCLP -- said that the complexity of the updated renewal forms is causing a high number of enrollees to not respond. She said, "Our concern is that a lot of them don't really understand what's going on and haven't had an opportunity to provide the adequate information."

The groups that filed the suit are applying for a temporary restraining order to prevent DHCS from canceling coverage for those who have not received proper notification.

Reaction

Connie Lo, health programs coordinator at Asian Americans Advancing Justice in Los Angeles, said that the renewal forms pose a language barrier for many Medi-Cal enrollees. She said, "They don't even know what these packets are for and why they're receiving so many documents together that they can't even read."

Cori Racela, a staff attorney at Neighborhood Legal Services of Los Angeles County, added that the forms are difficult to understand even for English-speaking enrollees.

DHCS declined to comment on the lawsuit. However, before the suit was filed, DHCS Deputy Director of Health Care Benefits and Eligibility Rene Mollow said that the department tried to make the renewal forms as simple as possible within a short timeline. She added the forms should be easier to use next year (Kaiser Health News, 11/18).