CA Health Care Patients Punished by Paperwork

Health care is even more top of mind for Californians as we go through the year-end ritual of enrolling in insurance for 2024.

For those families on Medi-Cal, the state’s insurance program for the poor, it can be even more complicated, writes CalMatters health reporter Ana B. Ibarra. Six months after the state restarted its health insurance eligibility process, more than 835,000 people who had their Medi-Cal terminated between June and October lost that coverage because of incomplete or missing paperwork.

California also ranks the fourth worst in the country in terms of coverage terminations related to “procedural issues,” according to a tracker by KFF (formerly The Kaiser Family Foundation). Under this category, the reasons why eligible people lose coverage vary: People are unprepared; they’re unaware the verification process restarted; they moved and did not receive the renewal alerts; or they did submit their paperwork but county offices may not have processed them on time.

In response, the assistant deputy director at the California Department of Health Care Services said the state has been receiving assistance from the federal government to increase the number of cases that can be renewed automatically. Eligible people who lose their Medi-Cal also have a chance to re-enroll if they submit any missing information within a 90-day grace period.

To learn more about Californians losing Medi-Cal coverage, read Ana’s story.

Speaking of health care, California faces a significant shortage of nurses, and it partly falls on universities to train more to replace those who are retiring or leaving the state.

Christopher Buchanan and Jacqueline Munis of CalMatters’ College Journalism Network report that private nursing schools are teaching more students each year, filling in the gaps as public universities struggle to grow their nursing programs.

In 2021, 55% of the 16,600 spots in associate, bachelor’s, and master’s degree nursing programs were at private institutions. Nearly 64,300 students applied, according to the California Board of Registered Nursing. Private nursing programs, which can cost up to seven times as much as public programs, also accounted for three times the number of students graduating with bachelor’s degrees as their public counterparts.

Nevertheless, a leader of the California Nursing Association union warned that if admissions for public schools stagnate and private school prices remain high, California could still lose more potential nurses to other states.

Read more about California private nursing programs in Christopher and Jacqueline’s story.

Health care includes mental health, and Gov. Gavin Newsom wants to make significant changes. But nearly all counties are slow to adopt one of the most major reforms that Newsom helped push — and he is not happy.

As Ana and CalMatters health reporter Kristen Hwang explain, the governor signed a law in October to significantly loosen the requirements around who can be placed involuntarily into mental health treatment. Fifty-six out of the state’s 58 counties have requested permission to delay the conservatorship policy until 2026, drawing ire from the governor during a Friday press conference: “The state has done its job. It’s time for the counties to do their job…. We can’t afford to wait.”

But county leaders argue that given the soaring number of people who need treatment, it’s important to implement the law right. Until they receive more guidance and secure resources for training and infrastructure, the lack of staff and funding make it difficult to move the new law forward.

Nora Vargas, San Diego County board of supervisors chairperson, in a statement to CalMatters: “San Diego County will implement (the conservatorship law) in a way that is methodical and equitable because these are real people and real families seeking care.”


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