The Stories Behind the Medi-Cal Backlog

In an article published Monday, I wrote about the policy decisions that contributed to the massive Medi-Cal backlog. Through interviews and state documents, we revealed that the state prioritized Covered California’s insurance enrollment system over one for Medi-Cal, leading to a backlog of about 900,000 applications from low-income people.

There are 900,000 stories of people across California trying to get the health insurance they are now eligible for under the federal Affordable Care Act. Some of them have been trying since last fall to sign up for Medi-Cal.

Last week, I heard from Amy Arambula, an attorney on the health team at Central California Legal Services who was trying to help a woman and her son, whose Medi-Cal applications had been stuck in the backlog since early October.

The 49-year-old woman, who lives in Tulare County and is a seasonal farm-worker, first applied for health insurance through Covered California, the state’s open-marketplace exchange.

“My client received a letter from Covered California in December, advising that she did not qualify for Covered California, but appeared Medi-Cal eligible based on her 2012 earnings of $19,500,” Arambula wrote in an email message. “We are not sure whether her application was forwarded to the county.”

After hearing nothing from the county for almost three months, the woman applied for Medi-Cal again in late December. She had just been laid off from her packinghouse job four months earlier than she expected due to a freeze.

The mother had several interviews with the Tulare County Health and Human Services Agency in January and February, and provided various income and residency documents.

When her Medi-Cal card still hadn’t arrived by late April, she called the legal services helpline.

“She is extremely worried, because she knows she must have health insurance and, yet, despite her best efforts, numerous calls and visits to answer questions and provide documents, she hasn’t been able to get her application approved,” Arambula wrote last week.

After a seven-month ordeal, the woman got word Tuesday morning that her Medi-Cal application had finally been approved, Arambula said.

There are about 900,000 other California residents who are still waiting.

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