Dive Brief:
- California still has a huge and growing backlog of Medi-Cal applications blocking the state's Medicaid expansion efforts under the Affordable Care Act.
- The California Dept. of Health Care Services reported 800,000 pending applications in April; by May, it reached about 900,000 and hasn't budged much. As the state handles older applications, new ones continue each day to enter a system plagued by computer glitches and inefficient procedures for verifying applicants' personal information.
- In addition to delayed processing, the state has fallen behind in sending final enrollment notifications. Many people awaiting word are continuing to go to costly emergency rooms as they did previously, while others are putting off care. Medi-Cal coverage is retroactive from the time eligible patients apply, but not everyone trusts that until they have a card in hand.
Dive Insight:
Part of the problem is high demand, Kaiser Health News said. In California, as in many of the 26 states opting to expand Medicaid under the ACA, people turned out in much higher-than-projected numbers. California expects 2.2 million people to enroll in Medi-Cal in July, 300,000 more than estimated last fall.
Since last fall, fully 40% more people have signed up for Medi-Cal than for enrollment in private insurance plans through Covered California, the state’s health insurance exchange.
California has been ahead of the curve on ACA implementation, and it conducted a massive outreach campaign. Yet a state official told KHN that the state didn't expect so many applications. Critics suggest it was a matter of priorities: launching the exchange was put ahead of improving the online enrollment process for Medi-Cal patients, despite their great numbers.