Thousands of Former LIHP Members Might Fall Into Coverage Gap
About 24,000 California residents who were covered by the Low Income Health Program before the program ended on Jan. 1 might fall into a coverage gap because they do not qualify for Medi-Cal and many are unaware of how to enroll in coverage through Covered California, the state insurance exchange, HealthyCal reports. Medi-Cal is California's Medicaid program (Guzik, HealthyCal, 2/27).
Background on LIHP
LIHP was designed as a bridge to 2014 health care reform efforts. The program primarily served individuals with incomes below 138% of the federal poverty level, including:
- Uninsured, childless adults ages 19 to 64; and
- Parent and caretaker relatives.
When LIHP coverage ended in January, the California Department of Health Care Services announced that it had transferred more than 630,000 beneficiaries from the program into Medi-Cal.
The remaining 24,000 members of the program who did not qualify for Medi-Cal were encouraged to obtain coverage through the state's health exchange (California Healthline, 1/2).
Details of Coverage Gap
According to HealthyCal, there is no way to track how many of the 24,000 individuals who did not qualify for Medi-Cal ended up enrolling in coverage through the state insurance exchange.
In addition, observers say that while some individuals are aware that they can enroll in coverage on the state exchange, many do not understand how to do so.
Dee Pupa, manager of LIHP in Ventura County, said such individuals are "falling through the cracks," adding, "Health care reform is very complex ... the typical person in the community, they don't understand" how to navigate the exchange.
Even though some individuals from the LIHP program will qualify for federal subsidies, coverage could still be too expensive for them because it is more comprehensive and offers more services, according to HealthyCal (HealthyCal, 2/27).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.