With a COVID-19 state of emergency terminated, the return of eligibility checks for people on public assistance in California is set to leave as many as 200,000 Orange County residents without money for doctor visits and medication refills. 

For the first time since the start of the pandemic, people covered under Medi-Cal must provide their income information to the state this year, which will determine between April of this year and May of next whether they can still enjoy free and low cost health services.

Important Information
To see if you qualify for Medi-Cal based on income, click here.
Your coverage will end if you don’t turn in a renewal form and everyone has a different renewal date. Check the mail for a yellow envelope with a renewal form.
The quickest and easiest way to complete your renewal is online through BenefitsCal or MyBenefitsCalWIN.
If you fail to renew or end up over the income limit, click here.

It stands to impact everyone from seniors and children to people living on the streets.

And it has county supervisors and community health leaders questioning who exactly will fall between the cracks as they try to get the word out for folks to get going on their renewal process.

Or what kind of trouble it might spell for OC’s trust-built network of community health clinics.

“That’s the story of our life – we’ve always been expected to do more with less,” said Isabel Becerra, CEO of the Coalition of Orange County Community Health Centers, in a Tuesday phone interview. 

Her organization supports clinics providing free health services to underserved and monolingual people living across OC.

While such clinics serve people regardless of whether they’re covered, they still have to sustain themselves through a series of federal and state grants.

The clinics also rely on reimbursements from the public health plan some of their clients are on.

“When that patient walks in your door, you are responsible for a comprehensive level of services,” said Becerra, also a CalOptima Board Director. “Dental, behavioral health, vision, OB/Gyn, health education, nutrition services.”

Now an expected drop in OC’s covered population has Becerra wondering whether an “already impacted” health network might be further “fractured.”

The concern is echoed by the leader of three community health clinics in Tustin, Garden Grove and Fountain Valley.

“The loss of patients covered under Medi-Cal directly impacts the revenue of community health centers, creating budget deficits,” said Alexander Rossel, CEO of Families Together of Orange County, in a Tuesday email. “As a result, services not covered under Medi-Cal, such as food pantries and wellness programs, may face cuts.”

The loss of Medi-Cal covered patients will also “ultimately lead to increased reliance on community health centers and emergency rooms, causing unnecessary expenses and straining resources,” Rossel said.

While federally-qualified health centers often get larger reimbursements, only 17 of OC’s 30 community health centers enjoy that status.

“And also it’s expected that that offsets some of the costs for your uninsured population, right? Because your uninsured population, for whatever reason, may be uninsured indefinitely, or through lapses like this when they lose coverage.”

One federally-qualified center with locations across OC is called Korean Community Services, but its leader, Ellen Ahn, said she isn’t thinking that far ahead.

“What I’m most concerned about is the messaging not reaching communities,” Ahn said in a Tuesday phone interview. 

On top of disqualifying income changes, residents could also lose their coverage simply by being unaware.

At their most recent board meeting on May 23, the OC Board of Supervisors sent their clearest signal yet about the healthcare access crisis on their hands, approving a resolution which called Medi-Cal redeterminations a “serious risk” to vulnerable residents’ safety net.

Supervisor Vicente Sarmiento, whose district represents some of OC’s most working-class neighborhoods, called the upcoming renewal situation “an incredibly large challenge” for those who are not only the most vulnerable, “but probably the least able to navigate this process,” be it through language barriers or disabilities. 

Even those who are eligible “could lose their coverage due to a few things,” CalOptima CEO Michael Hunn told county supervisors that day.

“One: Just lacking an understanding of the process to changes of address and other contact information in their profile that prevent the recipient receiving their renewal notices and follow-up outreach,” Hunn said. 

Also: “The paperwork that’s required to be filled out, which can be as many as 20 pages.”

It could also widen the health gap throughout the county, which the pandemic put under a magnifying glass.

“We have enough health equity issues in Orange County as is,” Ahn said. 

“Adding 200,000 more people without health coverage – it’s exacerbated. We’re coming out of a pandemic where a lot of low income communities got sucker punched,” she added.

Meanwhile, CalOptima has committed $6 million in spending to support up to 100 enrollment navigators helping people fill out their forms. 

“In such a short period of time, we can’t possibly catch them all,” Becerra said.

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