Senate Raises Concerns About Medi-Cal Backlog and Exchange Outreach Effort

On Thursday, state Senators raised a number of concerns about the readiness of Medi-Cal to handle the expected rush of new enrollees during Covered California’s second open enrollment period and questioned the exchange’s outreach plan.

The health insurance exchange’s second enrollment period begins Nov. 15 and runs until Feb. 15, 2015.

The primary and repeated worry of legislators at yesterday’s Senate Committee on Health informational hearing was the backlog of unfinished Medi-Cal applications at the Department of Health Care Services, which oversees Medi-Cal.

“My office on a regular basis is getting calls,” said committee chair Sen. Ed Hernandez (D-West Covina). “It can be anything from network adequacy to call time [at Covered California call centers] to wait time to length of time in Medi-Cal to get enrolled.”

That backlog and long wait for Medi-Cal applicants particularly bothered Sen. Jim Beall (D-San Jose). “When I look ahead at next year, I have to wonder,” Beall said. “Do we have the backlog taken care of by Nov. 15? Or is it going to impact the enrollment process?”

DHCS Director Toby Douglas said the peak of 900,000 unprocessed Medi-Cal applications in March has been trimmed to a backlog of about 171,000.

“We know our implementation has not been without problems,” Douglas said. “We’re currently at 171,681 pending applications. A lot [of them] we’re awaiting verification … to make a final disposition. … There are at least 40,000 that are duplicates.”

Douglas said the state also is “looking at the option of enrolling kids in presumptive eligibility.”

Sen. Holly Mitchell (D-Los Angeles) raised a different issue — the need for stronger minority outreach at Covered California.

“The effort in the first go-round was lackluster,” Mitchell said. “We need to have a conversation about who is doing the outreach.”

Peter Lee, executive director of Covered California, said that concern has been on the front burner for the exchange’s second open enrollment period.

Sen. Bill Monning (D-Carmel) wanted to know: “What are you doing to monitor access? Our phones are ringing off the hook with people who say they can’t access providers, and coverage without access is not real coverage.”

Lee said that has always been a primary concern for the exchange, right up there with affordable premiums.

“If we don’t deliver on the promise of care,” Lee said, “we’re not going to re-enroll people. Part of what the [Covered California health] plans came in with is expanded networks. We have a legal requirement to make sure people do get access to care.”

Related Topics

Capitol Desk Covered California Medi-Cal