MEDI-CAL: Fear, Misconceptions Hurt Public Clinics
As the number of Medi-Cal beneficiaries gradually declines, "community clinics [are] on shaky financial ground" because they rely on Medi-Cal reimbursements to pay for care for the uninsured, the Fresno Bee reports. From January 1996 to January 1998, the number of Medi-Cal clinic patients decreased by 14.6% -- from 563,250 to 480,789, according to a UC-San Francisco study. While UCSF researchers assumed the decline was due to the program's change from fee-for-service to managed care, they instead discovered that the decrease could be attributed to a statewide decline in beneficiaries. "Our sense is that these safety-net clinics are just struggling to hang on, and they're facing more uninsured patients who don't bring any money with them," Kevin Grumbach, chief of family and community medicine at San Francisco General Hospital Medical Center, said. Each month, more than 23,000 Californians go without health coverage.
Why No Beneficiaries?
A survey of Medi-Cal applicants, taken during a six-month outreach period in Fresno County, found that fear of "public charge" and immigration issues are barriers to eligible individuals' enrollment. Individuals also cited language barriers, complicated application forms and proving eligibility as deterrents to enrolling. According to a Medi-Cal Policy Institute study, 92% of respondents said the sign-up process is "harder than it should be," while 78% said "too much paperwork and documentation is required to enroll." Sixty percent indicated that locations used to sign up for the program are "unpleasant" and 59% said that hours are "inconvenient." In the meantime, as "[f]ear and misinformation about welfare reform are keeping many people who would likely still qualify for Medi-Cal from applying," clinics suffer because they must provide medical care to everyone, regardless of income, if they are to receive federal funds. Subsequently, clinics and local governments have begun "mounting outreach efforts to encourage qualified people to apply for Medi-Cal" (Anderson, 4/2).