Covered California

By JUDY LIN Associated Press
Sept. 9, 2014 – 01:44 p.m.

SACRAMENTO, Calif. (AP) — Some Californians who purchased individual health coverage through the state’s insurance exchange are suddenly being dropped or transferred to Medi-Cal, the state Medicaid program for the poor that fewer doctors and providers accept.

Covered California, which is responsible for determining and directing Californians to an appropriate health plan, has no estimate of how many people are affected, saying only that the changes are occurring as incomes are checked to verify the policyholders can purchase insurance through the exchange.

Since the shifts often happen without warning, there’s confusion and anger among policyholders.

Glendale resident Andrea Beckum learned last month that she and her husband had been shunted to Medi-Cal only after getting a call from their insurance broker telling them their Anthem Blue Cross policy had been canceled. It’s a mystery because they make above the $21,707 threshold for two people to qualify for Medi-Cal, she said.

When the couple met with Los Angeles County social service workers, they were told they make too much to qualify for Medi-Cal. Now they are uninsured and considering an appeal.

“That’s the crazy part,” said Beckum, 35, a part-time neuropsychology researcher. “Even if we were in Medi-Cal, we don’t qualify for Medi-Cal.”

Covered California launched the online marketplace in October 2013 as part of the state’s implementation of the federal Affordable Care Act. The exchange offers sliding-scale subsidies for private coverage to lower-income and middle-class people with no access to health care on the job, and directs the poor to county social service offices for Medi-Cal.

Assemblyman Richard Pan, D-Sacramento, who chairs the Assembly Health Committee, said he will hold a hearing on Sept. 23 and look, among other things, at why people are losing coverage and what can be done to reduce interruptions.

“Implementing the Affordable Care Act, clearly it’s not something that just stops at the end of open enrollment,” Pan said. “There are ongoing issues.”

Officials at Covered California acknowledged that a number of people are being shifted around during income checks and eligibility updates.

“It will happen continually,” spokesman Dana Howard said.

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