‘Share-of-Cost’ Payments Hurt Finances of Many Medi-Cal Beneficiaries

The Sacramento Bee today examines the situation faced by a group of Medi-Cal beneficiaries who must pay a portion of their health care costs out-of-pocket because they earn slightly too much money. Under Medi-Cal rules, beneficiaries with incomes above 133% of the poverty level, or $969 per month, are charged monthly "share-of-cost" payments to cover a portion of their care. The payments are based on how much remaining income the government determines beneficiaries need to live a "subsistence lifestyle" -- about $600 per month in California. As a result, a beneficiary with an income of $970 per month -- $1 over the limit -- would pay about $370 in monthly share-of-cost charges toward their health care. The payments, which affect about 49,000 beneficiaries statewide, often make it difficult for beneficiaries to buy food and pay rent, the Bee reports. "The bottom line is that people are just not going to get health care," Angela Gilliard, a lobbyist at the Western Center on Law and Poverty, said, adding, "People are just going to die. Emergency rooms are going to get saturated, and people are literally not going to make it." Last year, Assembly member Wilma Chan (D-Oakland) introduced legislation that would have reduced share-of-cost payments for about 14,000 beneficiaries. The Assembly approved the $16.7 million-a-year bill, but the Senate has not yet considered it because of the state's multibillion dollar budget deficit. Chan said she has not decided if she will reintroduce the bill during the next legislative session (Furillo, Sacramento Bee, 11/5).