Requiring more frequent eligibility checks for California Medicaid will affect children's coverage, increase costs

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A plan by California Gov. Arnold Schwarzenegger (R) that would require most Medi-Cal beneficiaries to complete eligibility forms four times per year, rather than annually, will affect children the most and will not save the state money in the long run, according to a report commissioned by the California Endowment, the Sacramento Bee reports.

Medi-Cal is the state's Medicaid program. Administration officials estimate that the requirement will result in 122,000 people being dropped from Medi-Cal in the next fiscal year, which would save the state $95 million.

According to the report, previous studies have found that up to two-thirds of beneficiaries who were dropped from the program for reasons related to missing or incomplete eligibility forms re-enrolled in the program within eight months. The report found this cost the state $120 to $160 to re-enroll each child.

Gerry Fairbrother, author of the report and a researcher at Cincinnati Children's Hospital, said, "The data clearly show that a more frequent requirement would result in more children losing their health coverage, which causes lapses in health care that result in higher medical service costs once the child is re-enrolled."

Stan Rosenstein, director of Medi-Cal, said that the report overstates the costs of re-enrolling beneficiaries and that disenrollment "only occurs if somebody has to reapply and they haven't responded to two notices we sent them" (Rojas, Sacramento Bee, 4/17).

The report is available online.


Kaiser Health NewsThis article was reprinted from khn.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.

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