Dive Brief:
- A recent policy change in Covered California eligibility has resulted in 1,900 pregnant women being transferred into Medi-Cal without their consent or prior notice, California Healthline reported.
- Covered California acknowledged and blamed the situation partially on a computer glitch, which it stated wouldn't be fixed until September.
- A similar issue is affecting some pregnant women who purchased plans via HealthCare.gov across 38 states, which is also related to computer problems, Judith Solomon, vice president for health policy at the Center on Budget and Policy Priorities told California Healthline.
Dive Insight:
The issue in California is related to a recent policy change last October. Women who are pregnant when they enroll for health coverage and whose household income falls between $22,100 and $34,100 for a family of two are automatically placed in Medi-Cal. Previously, women had a choice between Medi-Cal and Covered California but were often not informed of the choice.
Women with the same income range as above who already had Covered California plans before pregnancy are supposed to be given a choice to remain with their plan or move to Medi-Cal, which is free. However, the Covered California computer system wasn't programmed to give enrollees the choice and some pregnant women were moved into Medi-Cal without notice when they reported their pregnancy to Covered California.
Although many women were distressed since the two agency's provider networks don't always overlap and they could no longer stay with their doctors, some considered the move to Medi-Cal a bonus since it covers delivery costs, CHL noted.
Amy Palmer, Covered California's director of communications, confirmed women who report their pregnancy through Covered California's website will be moved to Medi-Cal without a choice until the computer issue is resolved. However, they can get their plans reinstalled, retroactive to the date they reported their pregnancies, via Covered California's customer service call center.