Report Raises Questions About Governor’s Plan for Medi-Cal Eligibility

Gov. Arnold Schwarzenegger's (R) proposal to require most Medi-Cal beneficiaries to complete eligibility forms four times per year, rather than annually, will affect children the most and will not save the state money in the long run, according to a new report commissioned by the California Endowment, the Sacramento Bee reports. Medi-Cal is California's Medicaid program.

Administration officials expect the requirement to result in 122,000 people being dropped from Medi-Cal in the next fiscal year, which would save the state $95 million.

However, the report noted that previous studies found that about two out of three beneficiaries dropped from Medi-Cal for reasons related to missing or incomplete eligibility forms re-enrolled in the program within eight months.

According to the report, the state pays $120 and $160 to re-enroll each child in Medi-Cal. It adds that the savings from reduced enrollment will be offset by additional medical needs of children who re-enroll in the program.

Gerry Fairbrother, author of the report and a researcher at Cincinnati Children's Hospital, said the requirement will "result in more children losing their health coverage, which causes lapses in health care that result in higher medical service costs once the child is re-enrolled."

Stan Rosenstein, director of Medi-Cal, said the report overstates the costs of re-enrolling beneficiaries, and disenrollment "only occurs if somebody has to reapply and they haven't responded to two notices we sent them" (Rojas, Sacramento Bee, 4/17).