study issued earlier this year<\/a> by the UCLA Center for Health Policy Research and the UC Berkeley Labor Center projects that as many as 249,000 of those people could lose their plans over the next two years. The same study projects that by 2028, the number of newly uninsured could rise by 1.1 million in Los Angeles County, by 189,000 in Riverside County and by 177,000 in San Bernardino County.<\/p>\nThose estimates are based on new work-requirement\u00a0and immigration rules that HR1 mandates for Medicaid, and on other changes coming to Medi-Cal that are being imposed by the state. The combined result will be a mass exodus; the forecasters from UCLA and Berkeley project that nearly 3 million people in California will leave Medi-Cal over the next 24 to 32 months.<\/p>\n
County officials who administer federal health insurance locally aren\u2019t, yet, so specific.<\/p>\n
They said federal and state officials are still hammering out details of the new rules for federal health insurance and, because of that, they could only say that about 330,000 people in the county are likely to be affected by those rules and that many of them eventually could fall out of coverage.<\/p>\n
\u201cUntil we have full clarity on the exemptions that will be allowed by the state, we can\u2019t project any specific numbers,\u201d said Mike Edmundson, who directs Orange County\u2019s Assistance Program Division, which helps determine who is and isn\u2019t eligible for Medi-Cal, which in Orange County typically is provided by the county\u2019s CalOptima Health system or Kaiser Permanente.<\/p>\n
\u201cWe can only anticipate that there\u2019s going to be a decrease.\u201d<\/p>\n
What is known, or at least widely agreed upon, is that all that lost insurance will be painful.<\/p>\n
For tens of thousands of locals, routine medical check-ups will stop being routine. Screenings for cancer and heart disease will be skipped. Drugs that manage or stave off illnesses like diabetes and blood clots will be taken less if at all.<\/p>\n
Though there isn\u2019t a data point for it, the new rules will touch so many people, and take away so much health care, that at least some of the newly uninsured will die.<\/p>\n
And it\u2019ll boost costs for everyone else.<\/p>\n
The people who lose coverage, Edmundson said, will go to hospitals and emergency rooms for care when they become acutely ill or injured, instead of seeking less expensive and typically more effective preventative care. Though the county and the state have yet to make an official financial projection on what those visits will cost insured people and taxpayers, he said the finances are being studied.<\/p>\n
\u201cIt\u2019s going to tax the hospital system. And if people can\u2019t pay their bill because they\u2019re uninsured, it has to be passed along somewhere.<\/p>\n
\u201cI know that there is significant concern about the cost implications of these changes.\u201d<\/p>\n
What\u2019s more, the people targeted for new work rules are working-age adults, ages 19 to 64. When those people can\u2019t meet those requirements (generally by working at least 20 hours a week or volunteering or studying a similar time), their removal will add financial stress to the system.<\/p>\n
\u201cAs individuals fall off of coverage, who are younger and presumably healthier than the people who remain in the system, it\u2019ll have downstream effects,\u201d Edmundson said.<\/p>\n
\u201cThe cost of paying for coverage is going to go up.\u201d<\/p>\n
But that\u2019s in the future, and it\u2019s only a possibility. For now, the county and other Medi-Cal offices around the state are scrambling to make sure they\u2019re ready when the new HR1 rules kick in, dates that aren\u2019t yet set in stone. They\u2019re uploading new rules into the California Statewide Automated Welfare System computer system.<\/p>\n
And they\u2019re starting to reach out to enrollees who might be affected; people like Matteo Hernandez, a 32-year-old landscape worker from Santa Ana who said he and his family have received Medi-Cal health insurance since the start of the pandemic.<\/p>\n
\u201cMy wife is who I\u2019m worried about,\u201d Hernandez said.<\/p>\n
\u201cI\u2019ve got a green card. I\u2019m good. But she\u2019s only got an application to be here under (asylum), so I don\u2019t know if she\u2019s going to keep staying on insurance or what.<\/p>\n
\u201cI\u2019m told the kids will be OK,\u201d he added, referencing children he said are 6, 9 and 11.<\/p>\n
\u201cBut if the new rules say (his wife) can\u2019t get insurance, I don\u2019t know what we\u2019ll do. She\u2019s pretty healthy, but still\u2026 \u201c<\/p>\n
The rules<\/p>\n
Hernandez is right to worry about his wife\u2019s health coverage.<\/p>\n
A key part of the new rules of HR1 \u2013 and recent changes by the state \u2013 is to push many different categories of immigrants away from federal health insurance.<\/p>\n
California, which previously has offered insurance to all kinds of immigrants, has already started to accommodate the federal mandates. On Jan. 1, for example, the state suspended a program that had allowed undocumented residents to receive Medi-Cal benefits. Though it\u2019s unclear how many were affected, roughly 120,000 undocumented people in Orange County were enrolled in Medi-Cal.<\/p>\n
The next key date is Oct. 1. That\u2019s when an HR1 rule is projected to kick in that will push people known as \u201clawfully present non-citizens\u201d \u2013 including immigrants who are seeking asylum or refugee status, former victims of human trafficking and violence, and others \u2013 out of Medicaid. Nationally, that could touch several million people; it\u2019s unclear how many will be from Southern California.<\/p>\n
Then, starting at some point next year, work-requirement rules similar to those set to begin in mid-June for recipients of (Supplemental Nutrition Assistance Program, known in California as CalFresh, will also kick in for Medi-Cal. Able-bodied people between the ages of 19 and 64 \u2013 meaning people without disabilities or mental health issues, or who are caring for younger children or aging parents \u2013 will have to prove they are working or volunteering or studying at least 20 hours a week in order to qualify for federally subsidized health care. An estimated 330,000 people in Orange County are expected to fall into that world, though Edmundson noted many of those people are already working.<\/p>\n
Also next year, all Medi-Cal enrollees will have to start reapplying for assistance every six months, instead of once a year as they do now. That shift, Edmundson said, will make it more expensive for the county to administer the program \u2013 by doubling the workload without offering any federal money for new employees \u2013 while also reducing the number of people who get help.<\/p>\n
\u201cWe tend to lose people when they fail to make contact,\u201d he said. \u201cThis is just more opportunity for that.\u201d<\/p>\n
Other rules \u2013 including requiring all but the lowest-income enrollees to pay $30 a month for their insurance \u2013 are expected to kick in over the next two years.<\/p>\n
For people who get insurance through their work, or through the federal marketplace, like consultant Tartabull, the bill might not come due for a couple years. But after that?<\/p>\n
\u201cWe\u2019ll be paying more,\u201d Tartabull said. \u201cI can\u2019t tell you, honestly, that I understand all the details of what\u2019s being discussed. But that much \u2013 we\u2019ll pay more \u2013 I totally get.\u201d<\/p>\n","protected":false},"excerpt":{"rendered":"As many as 16 million lower-income Americans are projected to lose their federally financed health insurance over the…\n","protected":false},"author":2,"featured_media":565835,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[59],"tags":[1340,97,252,253,3],"class_list":["post-565834","post","type-post","status-publish","format-standard","has-post-thumbnail","category-health-care","tag-congress","tag-health","tag-health-care","tag-healthcare","tag-news"],"_links":{"self":[{"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/posts\/565834","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/comments?post=565834"}],"version-history":[{"count":0,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/posts\/565834\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/media\/565835"}],"wp:attachment":[{"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/media?parent=565834"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/categories?post=565834"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/tags?post=565834"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}