California living is expensive. So imagine having to make do $600 a month. This is basically what some older people and people with disabilities have to do to access Medicalthe state health insurance program for low-income residents.
People with high medical costs — but whose income is too high to qualify for free Medical — can still access the program if they pay part of the cost.
This cost share functions as a monthly deductible; people are allowed to keep $600 for personal purposes and must spend the rest of their income on health expenses before their Medical the cover is in place.
“If you do $1,600 a month, $1,000 must be used to pay for your care,” said Tiffany Huyenh-Cho, an attorney at Justice in Aging, an organization that urges state lawmakers to update the income rule. Since people using this type of Medical usually have expensive care, for some it’s worth paying for, but most can’t afford it, she said.
In January, the last month for which state data is available, about 81,000 people were registered with Medical but couldn’t use it because they didn’t pay their share of the cost. The majority are over 65 or have a disability, according to the data.
Take Maxine Wells of San Diego — she is 91 years old, and with the help of her son, Keith Wellsshe recently applied for Medical. His Social Security monthly income of $2,000 puts it above the free coverage limit. Keith Wells is still waiting to get an official word from the state on her mother’s eligibility status, but isn’t sure they’ll be able to pay her share of the cost.
The dollar amount people can keep, $600 for an individual and $934 for a couple, has not changed since 1989, when the minimum wage was $4.25 one o’clock.
“It was shocking to learn that it hasn’t been updated since,” Keith Wells said.
old people love Maxine Wells are also eligible for Medicare, the federal health insurance program for the elderly and disabled. But Medicare doesn’t cover all of her needs or home care. Maxine Wells, a former beauty salon owner, is suffering from a heart attack that damaged her heart muscle. She suffers from chronic obstructive pulmonary disease, dementia and anxiety. Medical would supplement his Medicare coverage. About 1.4 million Californians are enrolled in both programs.
California implemented sweeping and nation-first policies to extend health insurance coverage to more people. It has one of the lowest uninsured rates in the country – around 6% of California residents do not have health insurance. Yet pockets of people continue to struggle to afford the coverage and care they need, which means they are going without.
Aging Advocates Say Older
adults tend to live on fixed incomes, but are sometimes subject to rules that have not kept up with today’s cost of living.
Aging and health advocates are now calling on lawmakers and the governor’s office to allow Medical beneficiaries who must pay a share of the cost of coverage to keep more of their income. Assembly Bill 1900 by Assemblyman Dr. Joaquin Arambulaa Fresno Democrat, proposes to raise the monthly limit of $600 for an individual, which is about 55% of the federal poverty level, at $1,562or 138% of the federal poverty level.
This adjustment would require federal government approval, according to the Department of Health Serviceswho oversees the Medical program.
Arambula’s bill recently passed out of the Assembly and is now before the Senate.
“It’s simply a matter of fairness for Californians who are struggling to make ends meet and need access to health care,” Arambula said of his bill at the hearing. of the Assembly Health Committee earlier this year.
Linda Nguy, a policy advocate with the Western Center on Law and Poverty, said it would be difficult to pass the bill if funding for it was not included in this year’s state budget. Funding for this proposal was not included in the governor’s budget review in May.
However, the version of the budget released Wednesday by the Democratic leaders of the Legislative Assembly allocates $31 million reduce the cost share for this population. The Legislature and govt. Gavin Newsom must now meet and determine a final budget.
The Office of the Legislative Analyst estimated that this proposal would cost between $53 million and $151 million, half of which would be paid for by the state and the other half by federal funds. Without that funding, Arambula’s bill would likely stall in the Senate tax committee, Nguy said.
At least nine other states and the District of Colombia allow people who pay a share of the costs Medical (Medicaid in other states) to retain a higher amount for personal use than California done, according to Kaiser Family Foundation.
“It’s so unfair,” said Naty Chavirateacher at Los Angeles region whose parents, Jose and Alicia Chavira, struggle to afford expensive medication and home help. “Do you know how hard my father worked? He paid his taxes, he’s a good citizen and here he is today in survival mode. I know his finances weigh on his health.
Jose ChaviraThe 77-year-old former welder struggles with a number of health issues and symptoms – diabetes, depression and dizziness, among others.
He has spent most of his retirement caring for his wife, Alicia, 78, a former housewife who raised six children and was diagnosed with Alzheimer’s a few years ago. But now his health is also deteriorating.
Naty Chavira would like her parents to get home help and her dad to get the hearing aids he needs, but Medicare won’t pay for these expenses, so she helped them apply Medical. However, to get this coverage, the couple could only keep $934 of their $2,600 monthly Social Security Income.
When you take $500 away for the bills they could keep $400 for their food and medicine. “It’s crazy,” Naty Chavira said.
CalMatters COVID-19 and Health Care Coverage is supported by grants from the California Blue Shield Foundationthe California Health Care Foundation and the California Wellness Foundation.