Friday, August 29, 2014

California Legislature Working Hard to Erase All Barriers to Free Healthcare in the State

*** Update: in late September, Gov. Brown did ultimately veto this bill.  ***

Some people actually refuse care when they know they might have to ultimately pay for it out of their estate.  California's Legislature wants to erase that fear and make sure basic medical services provided though Medi-Cal are always free; even if the recipient subsequently finds themselves out of financial difficulty and passes on with significant assets.

Over the past 20 years, California has recovered almost a billion dollars that paid for long-term care and basic health services through Medi-Cal under this program.  But our State Senate and Assembly just passed a bill changing that calculus.  The bill now sits on Governor Brown's desk.  

This is from Pauline Bartolone writing at Kaiser Health News (Hat tip to Angie Vitale for the pointer):
Federal law requires states to recoup money spent on institutional care, such as nursing homes, by Medicaid, the state-federal health care program for low-income people. [It is called Medi-Cal in California.]  But it also allows states to recover costs from people after they die if they received basic medical services through Medicaid at the age of 55 or older.

In California, advocates of [a new bill passed by the legislature and awaiting Gov. Brown's decision] say the current law is complicating enrollment in Medi-Cal, the state’s Medicaid program, with some people refusing to sign up, and others terminating enrollment for fear of not being able to pass on their estate. The state has enrolled 2.2 million people into Medi-Cal under the Affordable Care Act. 
According to Consumer Reports, California is one of 10 states that recovers funds from estates of Medicaid beneficiaries 55 and older for basic health services. The other states are Colorado, Iowa, Massachusetts, Nevada, New Jersey, New York, North Dakota, Ohio and Rhode Island. ... 
Anne-Louise Vernon had been looking forward to signing up for health insurance under Covered California. She hoped to save hundreds of dollars a month. But when she called to enroll, she was told her income wasn’t high enough to purchase a subsidized plan. 
“It never even occurred to me I might be on Medi-Cal, and I didn’t know anything about it," said Vernon. 
She said she asked whether there were any strings attached. 
"And the woman said very cheerfully, "Oh no, no, it’s all free. There's nothing you have to worry about, this is your lucky day.'” she recounted. 
Vernon signed up for Medi-Cal on the phone from her home in Campbell, Calif. Just months later, she said she learned online about a state law that allows California to take assets of people who die if they received health care through Medi-Cal after the age of 55. 
“So I called Medi-Cal and asked specifically, 'Does this mean what I think it means?'” she said. 
It means Medi-Cal managers can take part of her estate later for health care costs she’s accruing now. Vernon said she’s panicked and worried. She doesn’t get a monthly bill – so she’s not sure what she’ll be accountable for. ...