Exchange Reconsiders Rule for Medi-Cal Enrollment Assistance
At a board of directors meeting last week, Covered California officials considered changing a rule that requires certified insurance agents and brokers to help individuals enroll in Medi-Cal without compensation, State of Reform reports.
Medi-Cal is California's Medicaid program (Brumbach, State of Reform, 8/21).
Certified agents are required to help individuals enroll in Medi-Cal regardless of compensation under their contracts with the exchange (Covered California presentation, 8/20).
Executive Director Peter Lee said the policy was meant to ensure there is "no wrong door" for individuals seeking Medi-Cal coverage.
However, Covered California decided to reconsider the policy because its per-application funding ended on June 30, State of Reform reports.
Details of Proposal
During the meeting, exchange officials proposed two options to the board:
- Maintaining the existing policy; or
- Encouraging agents to help consumers, while also allowing them to refer Medi-Cal applicants to county eligibility workers (State of Reform, 8/21).
Officials presented the pros and cons of each option. For example, they said that maintaining the existing policy would enable one-step enrollment and allow consumers to access assistance from all certified agents. However, the certified agents could be less educated about Medi-Cal issues, according to the board presentation.
Meanwhile, officials said that modifying the existing policy would connect consumers with the assistance best suited to help them. However, consumers might not follow through under such a policy, the officials said (Covered California presentation, 8/20).
Julianne Broyles, with the California Association of Health Underwriters, said she supported the current policy. She said that referring consumers to county eligibility workers could hinder certified agents' ability to help consumers when they return to the commercial market. "Once we throw them over, we never see them again," she added.
However, she said that CAHU cannot continue to support the existing policy without funding.
According to State of Reform, Covered California has scheduled a stakeholder meeting for Aug. 28. Officials plan to offer a recommendation to the board in October (State of Reform, 8/21).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.