Thousands in L.A. Left Uninsured After Faulty Medi-Cal Transition

About 5,000 California residents who were supposed to be transitioned from a Los Angeles County health plan to Medi-Cal in January have been left without health coverage because of system and data inconsistencies, KPCC's "KPCC News" reports.

Medi-Cal is California's Medicaid program.

Background

As part of the Affordable Care Act's impending Medicaid expansion, L.A. County in 2011 received federal funding to enroll nearly 300,000 low-income individuals in a program called Healthy Way L.A. The enrollees were likely to be eligible for Medi-Cal coverage under the ACA's expansion of the program.

The goal was to transition Healthy Way L.A. members into Medi-Cal on Jan. 1, 2014, when the expansion took effect.

Details of Transition Errors

While the transition went smoothly for most Health Way L.A. members, about 5,000 individuals' information did not transfer correctly, and they were left without health coverage, according to "KPCC News."

Tangerine Brigham, director of the Los Angeles County Department of Health Services' Office of Managed Care, said the problem occurred because consumers' last names or birth dates in the Healthy Way L.A. system did not match state data. She said the state cannot transfer an individual into Medi-Cal unless the information matches.

Brigham said the county so far has resolved about half of the cases and is working to fix the rest. However, she noted that the process is slow because employees must manually correct each file and cross-check data with information from the county Department of Public Social Services. Brigham said DPSS workers also are processing about 200,000 new Medi-Cal applications from the state health insurance exchange.

Brigham said clinics should contact the county if they have a patient with urgent health needs, and the county will process their application immediately. Clinics have adopted varying policies for affected patients that do not have immediate medical needs, according to "KPCC News" (Florido, "KPCC News," KPCC, 4/23).