How does Medi-Cal Change in 2014?

1. Medi-Cal Expansion and Changes to Medi-Cal for AllJuly 19, 2013Board of Supervisors’ Obamacare BriefingKatie Murphy, NLSLA

2. How does Medi-Cal Change in 2014? • Most* Low-Income People will Get Medi-Cal starting in 2014 • Moving away from categories of “deserving poor” • HWLA patients all move into Medi-Cal • Medi-Cal will Change Dramatically for Everyone: • Simpler application and renewal • Some income limits go up • Income and household counted differently • No assets test for most • Some expansion of services • Changes for some in how they get care

3. HWLA = LA’s Bridge to Health Reform • 2011-2013 = HWLA • January 1, 2014 HWLA will =

4. Medi-Cal Expansion for New Applicants • Starting October 1, 2013, new applicants can apply for Medi-Cal under the new rules • It will be easier to apply!!! • Applicants can apply by themselves, with an government agency, at a health facility, through an assistor/CAA, through Covered CA: • By phone • Through the mail • Online • In-person • Coverage won’t start until January 1, 2014 unless they’re eligible under the old rules or HWLA

5. How will Medi-Cal change for everyone? • Income, assets and households are counted differently • Some income limits are going up (138%* for parents and indigent adults: $1,322 for a household of 1; $1,784 for 2; $2,247 for 3; $2,709 for 4; $3,171 for 5) • MAGI-based income text for most children, parents and expansion adults • Households are counted based on tax-dependents • No assets test for these MAGI populations • 19 and 20 years olds count as children in Medi-Cal • Domestic partners can count as caretaker relatives in Medi-Cal

6. Continued:How will Medi-Cal change for everyone? • Application changes: • One streamlined application for Medi-Cal and Covered CA • There can be a supplemental form to capture non-MAGI info • New verification procedures with state and federal databases • No documents needed if application info is “reasonably compatible” • Phone applications will be “quick sorted” and sent to the county if they’re likely Medi-Cal eligible • For “mixed families” (with likely eligibles in Medi-Cal and Covered CA), sent to Covered CA in the open enrollment period, but to the counties the rest of the time • Hospitals can qualify to make presumptive eligibility determinations for the MAGI populations

7. Continued:How will Medi-Cal change for everyone? • Simplified renewal of eligibility: • Passive for people who look eligible, pre-populated for others. • Phone renewals allowed. • Renewals based on changes mid-year resets the 12-month clocl. • Repeal of semi-annual reports • DHCS is seeking approval to: • Use CalFRESH application (for those under 65 and not disabled) to process Medi-Cal application • Automatically enroll parents with a child under 138% FPL • Use eligibility info from state-only and county-funded programs to automatically determine Medi-Cal eligibility

8. Continued: How will Medi-Cal change for everyone? • Legal immigrants under the 5 year bar will get Medi-Cal initially, then will be in Covered CA with a “Medi-Cal wrap” to cover costs and provide Medi-Cal benefits not in the Covered CA plan • Former Foster Youth can get Medi-Cal until their 26th birthdays if enrolled on 18th birthday. No income limit, no new application. • Expanded services: • Mental health and substance use services – some provided by plan, some by county mental health • Adult dental expansion • Plan choice: No presentation required anymore; state/county required to help with plan choice; will be online in spring 2014 for Medi-Cal

9. What Can You Tell Consumers NOW? • Medi-Cal isn’t going away, but lots of changes are happening • Spot tricky situations that may change for them • Help applicants get on HWLA NOW • Use other county programs if over-income, undocumented, or don’t meet 5 yr bar • For people over income, tell them to check Covered CA starting October 1, 2013

10. Questions or Problems with Health Care or Insurance? • Call 1-800-896-3202 For Free Legal Help & Advice on: • Public health programs such as Medi-Cal, HWLA • Private insurance • Help for the uninsured • Problems using and understanding managed care • Problems accessing or affording health care • Call Monday through Friday 9a.m. -5 pm. • (closed Wednesday from 1:30-3:30) Prepared by the Health Consumer Center of NLSLA