Obamacare: Legal aid groups demand answers on Medi-Cal backlog

Waiting for coverage
Potential enrollees at a North Hills screening event for Covered California and Medi-Cal in February. Hundreds of thousands of Medi-Cal applications have been delayed as the state and counties struggle with computer systems.
(Anne Cusack / Los Angeles Times)

With low-income Californians continuing to face months-long delays in getting state healthcare coverage, health advocates are calling on the state to explain within 10 days how it will address lingering Obamacare application delays.

In a letter to Gov. Jerry Brown and other officials Wednesday afternoon, the advocates demanded that California’s healthcare agency lay out specific plans for eliminating a huge backlog in applications for Medi-Cal, the state healthcare program for the poor.

“This has been a persistent problem for the last six months, and relief has been woefully insufficient so far,” said the letter from members of the Health Consumer Alliance, a group of legal aid organizations that help clients get care. “We cannot ... ignore the effect this backlog is having on our clients.”

The Affordable Care Act’s expansion of Medicaid -- the umbrella federal program that includes the state Medi-Cal service -- has been touted as a huge success in California. The state healthcare department has reported that Medi-Cal enrollment will surge from 7.9 million before ACA implementation to 11.5 million in 2014-15, covering about a third of the state’s population. 


But hundreds of thousands of new applications for the program have been bogged down by computer problems -- in many cases, for months.

In May, the department reported that 900,000 applicants were waiting to hear whether they were eligible for Medi-Cal. On Wednesday, spokesman Anthony Cava said that “the number of pending individuals is decreasing,” but did not provide updated statistics.

Katie Murphy, managing attorney at Neighborhood Legal Services of Los Angeles County, which is part of the Health Consumer Alliance, said ongoing bureaucratic delays had prevented many people from seeking needed medical care.

“It’s making people think health reform was an empty promise,” she said. “This is completely unacceptable.”


In their letter, the legal aid groups made recommendations to the state, including offering provisional eligibility to applicants who have waited longer than 45 days for a decision, accelerating eligibility for children and improving communication with applicants -- who currently receive “nothing, zero” in terms of updates on their applications, Murphy said.

Murphy said advocates would consider suing if the situation didn’t improve. “We’ve grown impatient with the department’s requests for us to be patient,” she said. “I’m sure people are working really hard on it, but that’s not acceptable anymore.”

Cava, the spokesman, said Wednesday afternoon that the department had not received the letter.

Many of the delayed Medi-Cal applications were filed by residents of Los Angeles County. The county’s Department of Public Social Services director, Sheryl Spiller, told members of the Board of Supervisors Tuesday that eligibility workers still are struggling with the state’s computer enrollment system.

In an interview Wednesday morning, department assistant director Anjetta Venters-Bowles said that as of Monday, the county was working to process 238,103 pending applications, with up to 45,000 new applications arriving each month.

For more on healthcare, follow me on Twitter: @LATerynbrown

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