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Los Angeles Times
07-08-2025
- Health
- Los Angeles Times
Millions of Californians may lose health coverage because of new Medicaid work requirements
The nation's first mandated work requirement for Medicaid recepients, approved by the Republican-led Congress and signed by President Trump, is expected to have a seismic effect in California. One estimate from state health officials suggests that as many as 3.4 million people could lose their insurance through what Gov. Gavin Newsom calls the 'labyrinth of manual verification,' which involves Medi-Cal recipients proving every six months that they are working, going to school or volunteering at least 80 hours per month. 'It's going to be much harder to stay insured,' said Martha Santana-Chin, the head of L.A. Care Health Plan, a publicly operated health plan that serves about 2.3 million Medi-Cal patients in Los Angeles County. She said that as many as 1 million people, or about 20% to 40% of its members, could lose their coverage. The work requirement will be the first imposed nationwide in the six-decade history of Medicaid, the program that provides free and subsidized health insurance to disabled and low-income Americans. It's relatively uncharted territory, and it's not yet clear how the rules will shake out for the 5.1 million people in California who will be required to prove that they are working in order to qualify for Medi-Cal, the state's version of Medicaid. After the 2026 midterm elections, millions of healthy adults will be required to prove every six months that they meet the work requirement in order to qualify for Medicaid. The new mandate spells out some exceptions, including for people who are pregnant, in addiction treatment or caring for children under age 14. Democrats have long argued that work requirements generally lead to eligible people l osing their health insurance due to bureaucratic hurdles. Republicans say that a work requirement will encourage healthy people to get jobs and preserve Medicaid for those who truly need it. 'If you clean that up and shore it up, you save a lot of money,' said House Speaker Mike Johnson of Louisiana. 'And you return the dignity of work to young men who need to be out working instead of playing video games all day.' Only three U.S. states have tried to implement work requirements for Medicaid recipients: New Hampshire, Arkansas and Georgia. One study found that in the first three months of the Arkansas program, more than 18,000 people lost health coverage. People can lose coverage a variety of ways, said Joan Alker, a Georgetown University professor who studies Medicaid. Some people hear that the rules have changed and assume they are no longer eligible. Others struggle to prove their eligibility because their income fluctuates, they are paid in cash or their jobs don't keep good payroll records. Some have problems with the technology or forms, she said, and others don't appeal their rejections. Of the 15 million people on Medi-Cal in California, about one-third will be required to prove they are working, the state said. Those people earn very little: less than $21,000 for a single person and less than $43,000 for a household of four. The state's estimate of 3.4 million people losing coverage is a projection based on what happened in Arkansas and New Hampshire. But those programs were brief, overturned by the courts and weren't 'a coordinated effort among the states to figure out what the best practices are,' said Ryan Long, the director of congressional relations at the Paragon Health Institute, a conservative think tank that has become influential among congressional Republicans. Long said advancements in technology and a national emphasis on work requirements should make work verification less of a barrier. The budget bill includes $200 million in grants for states to update their systems to prepare, he said. Arguments from liberal groups that people will lose healthcare are a 'straw man argument,' Long said: 'They know that the public supports work requirements for these benefits, so they can't come out and say, 'We don't support them.'' A poll by the health research group KFF found this year that 62% of American adults support tying Medicaid eligibility to work requirements. The poll also found that support for the policy drops to less than 1 in 3 people when respondents hear 'that most people on Medicaid are already working and many would risk losing coverage because of the burden of proving eligibility through paperwork.' In June, Newsom warned that some Californians could be forced to fill out 36 pages of paperwork to keep their insurance, showing reporters an image of a stack of forms with teal and gold accents that he described as 'an actual PDF example of the paperwork that people will have to submit to for their eligibility checks.' Many Californians already are required to fill out that 36-page form or its online equivalent to enroll in Medi-Cal and Covered California, the state's health insurance marketplace. Experts say it's too soon to say what system will be used for people to prove their work eligibility, because federal guidance won't be finalized for months. Newsom's office directed questions to the Department of Health Care Services, which runs Medi-Cal. A spokesperson there said officials are 'still reviewing the full operational impacts' of the work requirements. 'The idea that you are going to get a paper submission every six months, I'm not sure people have to do that,' Long said. Georgia is the only state that has implemented a lasting work requirement for Medicaid. Two years ago, the state made healthcare available to people who were working at least 80 hours per month and earned less than the federal poverty limit (about $15,000 for one person or $31,200 for a household of four). More than 100,000 people have applied for coverage since the program's launch in July of 2023. As of June of this year, more than 8,000 people were enrolled, according to the state's most recent data. The Medicaid program has cost more than $100 million so far, and of that, $26 million was spent on health benefits and more than $20 million was allocated to marketing contracts, KFF Health News reported. Democrats in Georgia have sought an investigation into the program. The Inland Empire agency that provides Medi-Cal coverage for about 1.5 million people in San Bernardino and Riverside counties estimated that 150,000 members could lose their insurance as a result of work requirements. Jarrod McNaughton, the chief executive of the Inland Empire Health Plan, said that California's 58 counties, which administer Medi-Cal, 'will be the ones at the precipice of piecing this together' but haven't yet received guidance on how the eligibility process will be set up or what information people will have to provide. Will it be done online? Will recipients be required to fill out a piece of paper that needs to be mailed in or dropped off? 'We don't really know the process yet, because all of this is so new,' Naughton said. In the meantime, he said, the health plan's foundation is working to make this 'as least burdensome as possible,' working to improve community outreach and connect people who receive Medi-Cal insurance to volunteer opportunities.
Yahoo
20-05-2025
- Health
- Yahoo
L.A. County is paying off millions in medical debt — no strings attached. Do you qualify?
Did you get a letter in the mail from the County of Los Angeles with the word "Undue" in bold blue? It's not a scam. It's a notification that your medical debt was cleared by the county. More than 134,000 Los Angeles County residents began getting notices in the mail Monday as part of the first wave of medical bill forgiveness made possible by the county's Medical Debt Relief Program. The first round of notices is expected to relieve more than $183 million in debt. The program was launched, in partnership with the nonprofit Undue Medical Debt, in December 2024 with the mission of providing financial relief for eligible residents by purchasing and eliminating the debt. The funds for the program were made possible by an initial $5 million investment approved by the Los Angeles County Board of Supervisors with additional funds from L.A. Care Health Plan and the L.A. County Medical Assn. The goal is to retire $500 million in medical debt for low-income residents, with plans to eliminate as much as $2 billion by seeking additional contributions from philanthropic partners, hospitals and health plans. That could mean the debt of millions of people would be wiped clean. Through this program, the county provides the funding and Undue Medical Debt acquires qualifying debts in bulk for a fraction of their face value from provider partners such as hospitals and health systems along with collection agencies. Far too many residents are "one medical bill away from fiscal catastrophe," said Holly Mitchell, Los Angeles County's 2nd District supervisor. "In 2023 alone, Los Angeles County residents held over $2.9 billion in medical debt," Mitchell said. Read more: Southern California cities top credit card debt list in new study Recently analyzed data from 2023 found that 1 in 9 adults in the county are impacted by medical debt, and "many are low-income families who even with a lifetime of work may never escape it," said Janice Hahn, Los Angeles County's 4th District supervisor. Adults with medical debt burdens are two to three times more likely to be food insecure, delay or forgo necessary medical care or prescriptions and experience housing instability than those without this burden, according to the data. Furthermore, the data say, about half of adults facing medical debt took on credit card debt to pay their medical bills. "This kind of debt often gets bundled and sold to debt collectors pennies on the dollar who go mercilessly after the families and aggressively for the payment," Hahn said. The relief program comes with no strings attached, so you don't have to pay taxes on it. The "Undue" notification in the mail will list how much debt was forgiven and where the debt was owed, such as the hospital, clinic or collector that was trying to collect from you. Since notices began hitting residences Monday, keep your eye out for the letters over the next few weeks. Eligibility for the program is determined by income, family size and whether the healthcare provider that is owed the money has chosen to participate in the program. To qualify for the program you must: Be a resident of Los Angeles County. Earn less or equal to 400% of the federal poverty level or have a medical bill that is 5% or more your annual household income. For example, in 2025, the income for a family of four that is 400% of the federal poverty level is $128,000. Have eligible debt, which means you must have a bill from a hospital or clinic that is participating in the debt relief program, the bill is past due and you are not using a payment plan for the bill. Read more: L.A. County approves $4-billion sex abuse settlement, largest in U.S. history No. If you and your bill qualify for the program, Undue Medical Debt will pay off your debt and you will be notified through the mail. Your bill qualifies for the program if the debt is held by hospitals, clinics or collectors that are participating in the program. The initial participating hospitals are Martin Luther King Jr. Community Hospital and Adventist Health White Memorial Hospital. County supervisors are calling on other debt holders to participate. Relief cannot be requested. If you received a letter from the county's Undue Medical Debt program, get in touch with the program online. If you need help with medical bills, visit the county's Department of Public Health online list of resources for support. Potential resources include applying for free or discounted hospital services, legal advice and consumer counseling. This program is not a scam: If the county has relieved your medical debt, you'll be notified by a letter in the mail from Los Angeles County and Undue Medical Debt. The envelope will have a county seal on it. Keep the letter as part of your records that the medical debt has been forgiven. Beware of alleged debt relief scammers that contact you via text, phone call or email. And don't fall for callers asking you to provide information or payment in exchange for medical debt relief. Sign up for Essential California for news, features and recommendations from the L.A. Times and beyond in your inbox six days a week. This story originally appeared in Los Angeles Times.
Los Angeles Times
20-05-2025
- Health
- Los Angeles Times
L.A. County is paying off millions in medical debt — no strings attached. Do you qualify?
Did you get a letter in the mail from the County of Los Angeles with the word 'Undue' in bold blue? It's not a scam. It's a notification that your medical debt was cleared by the county. More than 134,000 Los Angeles County residents began getting notices in the mail Monday as part of the first wave of medical bill forgiveness made possible by the county's Medical Debt Relief Program. The first round of notices is expected to relieve more than $183 million in debt. The program was launched, in partnership with the nonprofit Undue Medical Debt, in December 2024 with the mission of providing financial relief for eligible residents by purchasing and eliminating the debt. The funds for the program were made possible by an initial $5 million investment approved by the Los Angeles County Board of Supervisors with additional funds from L.A. Care Health Plan and the L.A. County Medical Assn. The goal is to retire $500 million in medical debt for low-income residents, with plans to eliminate as much as $2 billion by seeking additional contributions from philanthropic partners, hospitals and health plans. That could mean the debt of millions of people would be wiped clean. Through this program, the county provides the funding and Undue Medical Debt acquires qualifying debts in bulk for a fraction of their face value from provider partners such as hospitals and health systems along with collection agencies. Far too many residents are 'one medical bill away from fiscal catastrophe,' said Holly Mitchell, Los Angeles County's 2nd District supervisor. 'In 2023 alone, Los Angeles County residents held over $2.9 billion in medical debt,' Mitchell said. Recently analyzed data from 2023 found that 1 in 9 adults in the county are impacted by medical debt, and 'many are low-income families who even with a lifetime of work may never escape it,' said Janice Hahn, Los Angeles County's 4th District supervisor. Adults with medical debt burdens are two to three times more likely to be food insecure, delay or forgo necessary medical care or prescriptions and experience housing instability than those without this burden, according to the data. Furthermore, the data say, about half of adults facing medical debt took on credit card debt to pay their medical bills. 'This kind of debt often gets bundled and sold to debt collectors pennies on the dollar who go mercilessly after the families and aggressively for the payment,' Hahn said. The relief program comes with no strings attached, so you don't have to pay taxes on it. The 'Undue' notification in the mail will list how much debt was forgiven and where the debt was owed, such as the hospital, clinic or collector that was trying to collect from you. Since notices began hitting residences Monday, keep your eye out for the letters over the next few weeks. Eligibility for the program is determined by income, family size and whether the healthcare provider that is owed the money has chosen to participate in the program. To qualify for the program you must: No. If you and your bill qualify for the program, Undue Medical Debt will pay off your debt and you will be notified through the mail. Your bill qualifies for the program if the debt is held by hospitals, clinics or collectors that are participating in the program. The initial participating hospitals are Martin Luther King Jr. Community Hospital and Adventist Health White Memorial Hospital. County supervisors are calling on other debt holders to participate. Relief cannot be requested. If you received a letter from the county's Undue Medical Debt program, get in touch with the program online. If you need help with medical bills, visit the county's Department of Public Health online list of resources for support. Potential resources include applying for free or discounted hospital services, legal advice and consumer counseling. This program is not a scam: If the county has relieved your medical debt, you'll be notified by a letter in the mail from Los Angeles County and Undue Medical Debt. The envelope will have a county seal on it. Keep the letter as part of your records that the medical debt has been forgiven. Beware of alleged debt relief scammers that contact you via text, phone call or email. And don't fall for callers asking you to provide information or payment in exchange for medical debt relief.
