Millions to Join Medi-Cal Rolls

Law changes coming in 2014 will allow between 1.7 million and 3 million additional U.S. citizens and other legal California residents to begin applying for Medi-Cal, a government sponsored health care program funded with federal dollars.

Previously open only to families and disabled individuals, adults without dependent children in the household will now be allowed to apply. The program will also be open to people making as much as 138 percent of Federally determined poverty level wages (up from 100 percent of the federal number due to California’s high cost of living), currently around $31,000 annually for a family of four.

A study conducted by the Public Policy Institute of California suggests that those gaining access to the program are, as a whole, a younger population in comparable, or even better health than those currently participating. As long as eligible individuals who are currently healthy and do not often seek medical attention are enrolled, the per capita cost of providing coverage could decrease slightly.

Roughly 60 percent of the uninsured poor gaining Medi-Cal access are under age 40, with about 30 percent under age 25. From a cost perspective this is promising, as medical expenses for adults between the ages of 19 and 44 are half what they are for those aged 45 to 64. Even then, maternity and childbirth-related expenses account for a large share of costs attributed to the younger age bracket. For poor women, these costs are already largely absorbed by government.

Due to the program’s previous focus including families with children in the household, a large portion of the newly eligible participants are expected to be single adult males. Getting those eligible to enroll for coverage may be a challenge – since their income is so low, they’ll be exempted from penalties for failing to have medical insurance under federal law. Feeling that they don’t need coverage or frequent access to medical care, some members of focus panels held by the Institute did not express motivation to complete the paperwork or screening process to gain access to coverage.

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