Those With Medi-Cal Face Difficulty Accessing Care

Californians enrolled in the state’s low-income insurance program have more difficulty accessing health care than those with employer-sponsored insurance, a new study has found. The coverage gap was the greatest for people living in rural or suburban areas and for certain racial and ethnic groups.

Adults with Medi-Cal were more than twice as likely as those with employer-sponsored insurance to report that they don’t have a usual source of care other than the emergency room, according to the California HealthCare Foundation report released this month.

Meanwhile, children with Medi-Cal had significantly higher rates of visiting the ER in the past year. According to the research, 24 percent of children with Medi-Cal had been to the ER in 2012-13, compared with 13 percent of children with employer-sponsored insurance.

Nearly a third of Californians — about 12.3 million people — are enrolled in Medi-Cal.

“These findings underscore the importance of Medi-Cal for Californians,” the report states. “They also highlight challenges facing the Medi-Cal program and its health plan partners as they seek to provide levels of access to care for Medi- Cal enrollees that is equivalent to insured Californians, consistent with federal law.”

Using data from the 2012 and 2013 California Health Interview Surveys, researchers looked at dozens of health and access measures, comparing those with Medi-Cal and employer-sponsored insurance.

Adults with Medi-Cal fared worse on 59 percent of the measures, or on 29 of the 49 total. They scored better on just two of the measures and the same on 14.

Children with Medi-Cal fared better, scoring worse on 19 percent of the measures, or on six of the 31 total. Access to care for those children was better on two of the measures and the same on 20.

Adults living in suburban and rural areas who are enrolled in Medi-Cal reported the highest rates of not having a usual source of care other than the ER. About 32 percent of those in the suburbs and 26 percent living in rural areas reported not having a medical home. Comparably, just 16 percent of those in urban areas reported this.

The report also found disparities between racial and ethnic groups. A high proportion of Asians with Medi-Cal — 28 percent — reported that their doctor does not usually listen carefully to them, compared to 15 percent of all Medi-Cal enrollees.

Adults with Medi-Cal who speak Spanish reported increased difficulty finding a doctor that would take them as a new patient. About 36 percent said they had been told a doctor wouldn’t take them as a patient, compared with 7 percent of all Medi-Cal enrollees who had been told this.

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