Thousands of low-income people in the central San Joaquin Valley have applied for Medi-Cal in the past three months, an enrollment surge county officials attribute to the Affordable Care Act.
Medi-Cal applications in the impoverished Valley have surpassed enrollment by individuals in health plans offered through Covered California, the state's health benefit exchange.
"It's the demographics of the area we live in," said Kerry Hydash, president and CEO of Family HealthCare Network, a nonprofit that runs health centers in Tulare County.
Under the Affordable Care Act, a person can earn up to $15,856 a year and qualify for Medi-Cal. Covered California plans are designed for people with incomes above the Medi-Cal income cutoff.
Valley residents are coming to clinic offices to sign up for Covered California health plans and avoid a tax penalty next year. They're leaving with completed Medi-Cal applications, Hydash said. "Sixty (percent) to 70% going through the enrollment process end up being Medi-Cal."
Fresno County workers submitted about 12,000 Medi-Cal applications to the state between Oct. 1 and Nov. 30. The state was unable to provide county-by-county numbers for Medi-Cal enrollments after Sept. 30.
Clinica Sierra Vista, which operates health centers in Fresno, had enrolled about 5,000 as of Thursday.
Each month since October, enrollment has increased, said Kevin Hamilton, chief program officer. "We started out with about 800 in October and then in November we did a little over 2,000 and we've already gone over 2,000 for December," he said Thursday.
By contrast, 6,514 people in the central San Joaquin Valley had enrolled in subsidized and nonsubsidized insurance plans through the state's health benefit exchange through Nov. 30. Statewide, 109,000 had enrolled.
Acatitlan Martinez, 52, of Fresno, was enrolled in Medi-Cal at Clinica Sierra Vista's Elm Street campus.
Martinez, a farmworker, came to the office one day last week to enroll in a Covered California plan. "I heard it was a requirement to sign up for insurance because of the penalty," he said through a Spanish-language interpreter. He said he never thought about applying for Medi-Cal.
Medi-Cal enrollment also has benefited from a focus on Covered California's Monday deadline for individuals to enroll in health plans for coverage starting Jan. 1. Open enrollment in Covered California plans continues through March 31 for coverage in 2014.
Medi-Cal has no such deadlines — people can sign up year-round for the state-federal insurance program, and coverage begins as soon as eligibility is verified — but it's easy for people to be confused, said Sanja K. Bugay, deputy director of the Fresno County Department of Social Services.
And beginning Jan. 1, Medi-Cal benefits will be extended to low-income "childless adults" and working parents whose incomes slightly exceed the federal poverty line, which is $11,490 for a single person. There is a push to get those individuals enrolled in Medi-Cal before New Year's.
In Fresno County, 3,645 applications have been submitted for individuals who meet the expanded Medi-Cal guidelines, Bugay said.
But in October and November, 8,000 applicants met the old Medi-Cal eligibility rules — a 40% increase from the 2,500 to 3,000 applications the county typically receives each month, Bugay said.
Attention surrounding Covered California's enrollment deadline has to be the reason why so many people are applying, she said: "There's nothing else that really makes sense for us to have this increase."
as of Sept. 30
Fresno County: 336,885
Kings County: 39,666
Madera County: 50,105
Merced County: 94,400
Tulare County: 185,529
Statewide: 8.5 million
Source: California Department of Health Care Services
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