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"content": "\u003cp>The deadline to enroll in a health care plan through Covered California — \u003ca href=\"https://www.coveredca.com/\">the state’s health insurance marketplace that offers hundreds of low-cost coverage plans\u003c/a> — has been extended until Friday, Feb. 9.\u003c/p>\n\u003cp>Previously, the deadline to sign up for a plan was Wednesday, Jan. 31.\u003c/p>\n\u003cp>[pullquote align=\"right\" size=\"medium\" citation=\"Jessica Altman, executive director, Covered California\"]‘We want any Californian who needs health insurance to have the opportunity to get covered for the rest of 2024, and extending the open-enrollment period will ensure they have the time they need.’[/pullquote]State officials made the announcement \u003ca href=\"https://www.coveredca.com/newsroom/news-releases/2024/01/31/\">through a press release on Wednesday\u003c/a>, explaining that Covered California’s service center was recently taken offline in response to a cybersecurity incident that affected the third-party vendor that supports its phone lines. Many residents who tried to sign up for a health care plan by calling the service center experienced long wait times, the release said, which also noted that “at this time,” there was no indication that any members’ personal information was compromised.\u003c/p>\n\u003cp>“We want any Californian who needs health insurance to have the opportunity to get covered for the rest of 2024, and extending the open-enrollment period will ensure they have the time they need,” Covered California Executive Director Jessica Altman said.\u003c/p>\n\u003ch2>Ways to sign up\u003c/h2>\n\u003cp>Consumers have several ways to find a health care plan — not just over the phone. One option is visiting Covered California’s website at \u003ca href=\"https://www.coveredca.com/\">coveredca.com\u003c/a>.\u003c/p>\n\u003cp>If your job doesn’t provide health insurance and you don’t qualify for Medi-Cal, you may be eligible for a Covered California plan. Thanks to a mix of federal and state subsidies, many plans offer monthly premiums under $30.\u003c/p>\n\u003cp>If you are undocumented, you can also look for an insurance plan through Covered California — but you’ll have to meet the income requirements for Medi-Cal.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>California is one of two states \u003ca href=\"https://www.coveredca.com/learning-center/tax-penalty-details-and-exemptions/penalty/\">that requires residents to pay a penalty if uninsured\u003c/a>. The penalty for not having coverage the entire year would be at least $900 per adult when you file taxes this year. If you have a child under 18 that is dependent on you, that’s an additional $450 per kid.\u003c/p>\n\u003ch2>An increase in enrollment\u003c/h2>\n\u003cp>More than 243,000 people have already signed up this enrollment period, state officials said — \u003ca href=\"https://www.coveredca.com/newsroom/news-releases/2024/01/25/end-of-oe/\">a 13% increase from last year\u003c/a>. California already boasts one of the lowest uninsured rates in the country, with only 6.2% of non-elderly Californians lacking health insurance, \u003ca href=\"https://www.chcf.org/publication/california-achieves-lowest-uninsured-rate-ever-2022/\">according to a 2023 report from the California Health Care Foundation\u003c/a>. When the state launched its insurance marketplace in 2013, \u003ca href=\"https://calbudgetcenter.org/resources/continuing-the-path-towards-universal-health-coverage-in-california/#:~:text=The%20percentage%20of%20Californians%20without,uninsured%20rate%20was%20over%2017%25.\">the uninsured rate was around 17%\u003c/a>.\u003c/p>\n\u003cp>[aside label=\"Related Stories\" postID=\"news_11949192,news_11956545,news_11961980\"]The nation’s top health official, United States Health and Human Services Secretary Xavier Becerra, visited San Francisco on Tuesday to mark these new figures, and offered uninsured Californians a last push of encouragement to apply to Covered California (before the deadline extension was then announced on Wednesday).\u003c/p>\n\u003cp>“My mother would always say, \u003cem>mejor prevenir que remediar\u003c/em> — better to prevent than to remediate an illness,” Becerra said. “Health care insurance helps you prevent your children from becoming ill. If you don’t have insurance, you wait till they’re so ill they have to go to the hospital.”\u003c/p>\n\u003cp>At the national level, 21.3 million people nationwide enrolled in a health care plan this year through the Affordable Care Act (ACA) marketplaces. Many are receiving subsidies for their plans owing to the Inflation Reduction Act that Congress passed in 2022, and Becerra said he hoped Congress would vote to keep those subsidies in place.\u003c/p>\n\u003cp>Despite multiple attempts by Congressional Republicans each year to repeal ACA — also known as Obamacare — marketplaces have only grown since the health care law passed in 2010. “There was talk that when the Affordable Care Act launched, insurers would not buy in because it wouldn’t be a profitable enterprise for them,” Becerra said.\u003c/p>\n\u003cp>“Well, they’re in. Now what’s happening is they’re offering a panoply of plans; it’s tough to figure out which one is good for you,” he added.\u003c/p>\n\u003cp>“So we’re going to move more towards requiring the plans [to] provide some standardization, so people can make some good guesses about what might be good for them,” Becerra said.\u003c/p>\n\u003cp>\u003c/p>\n",
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"excerpt": "The deadline for Covered California health care enrollment was extended to give Californians 'the time they need,' Covered California Executive Director Jessica Altman said.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>The deadline to enroll in a health care plan through Covered California — \u003ca href=\"https://www.coveredca.com/\">the state’s health insurance marketplace that offers hundreds of low-cost coverage plans\u003c/a> — has been extended until Friday, Feb. 9.\u003c/p>\n\u003cp>Previously, the deadline to sign up for a plan was Wednesday, Jan. 31.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "‘We want any Californian who needs health insurance to have the opportunity to get covered for the rest of 2024, and extending the open-enrollment period will ensure they have the time they need.’",
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"content": "\u003cdiv class=\"post-body\">\u003cp>State officials made the announcement \u003ca href=\"https://www.coveredca.com/newsroom/news-releases/2024/01/31/\">through a press release on Wednesday\u003c/a>, explaining that Covered California’s service center was recently taken offline in response to a cybersecurity incident that affected the third-party vendor that supports its phone lines. Many residents who tried to sign up for a health care plan by calling the service center experienced long wait times, the release said, which also noted that “at this time,” there was no indication that any members’ personal information was compromised.\u003c/p>\n\u003cp>“We want any Californian who needs health insurance to have the opportunity to get covered for the rest of 2024, and extending the open-enrollment period will ensure they have the time they need,” Covered California Executive Director Jessica Altman said.\u003c/p>\n\u003ch2>Ways to sign up\u003c/h2>\n\u003cp>Consumers have several ways to find a health care plan — not just over the phone. One option is visiting Covered California’s website at \u003ca href=\"https://www.coveredca.com/\">coveredca.com\u003c/a>.\u003c/p>\n\u003cp>If your job doesn’t provide health insurance and you don’t qualify for Medi-Cal, you may be eligible for a Covered California plan. Thanks to a mix of federal and state subsidies, many plans offer monthly premiums under $30.\u003c/p>\n\u003cp>If you are undocumented, you can also look for an insurance plan through Covered California — but you’ll have to meet the income requirements for Medi-Cal.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>California is one of two states \u003ca href=\"https://www.coveredca.com/learning-center/tax-penalty-details-and-exemptions/penalty/\">that requires residents to pay a penalty if uninsured\u003c/a>. The penalty for not having coverage the entire year would be at least $900 per adult when you file taxes this year. If you have a child under 18 that is dependent on you, that’s an additional $450 per kid.\u003c/p>\n\u003ch2>An increase in enrollment\u003c/h2>\n\u003cp>More than 243,000 people have already signed up this enrollment period, state officials said — \u003ca href=\"https://www.coveredca.com/newsroom/news-releases/2024/01/25/end-of-oe/\">a 13% increase from last year\u003c/a>. California already boasts one of the lowest uninsured rates in the country, with only 6.2% of non-elderly Californians lacking health insurance, \u003ca href=\"https://www.chcf.org/publication/california-achieves-lowest-uninsured-rate-ever-2022/\">according to a 2023 report from the California Health Care Foundation\u003c/a>. When the state launched its insurance marketplace in 2013, \u003ca href=\"https://calbudgetcenter.org/resources/continuing-the-path-towards-universal-health-coverage-in-california/#:~:text=The%20percentage%20of%20Californians%20without,uninsured%20rate%20was%20over%2017%25.\">the uninsured rate was around 17%\u003c/a>.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>The nation’s top health official, United States Health and Human Services Secretary Xavier Becerra, visited San Francisco on Tuesday to mark these new figures, and offered uninsured Californians a last push of encouragement to apply to Covered California (before the deadline extension was then announced on Wednesday).\u003c/p>\n\u003cp>“My mother would always say, \u003cem>mejor prevenir que remediar\u003c/em> — better to prevent than to remediate an illness,” Becerra said. “Health care insurance helps you prevent your children from becoming ill. If you don’t have insurance, you wait till they’re so ill they have to go to the hospital.”\u003c/p>\n\u003cp>At the national level, 21.3 million people nationwide enrolled in a health care plan this year through the Affordable Care Act (ACA) marketplaces. Many are receiving subsidies for their plans owing to the Inflation Reduction Act that Congress passed in 2022, and Becerra said he hoped Congress would vote to keep those subsidies in place.\u003c/p>\n\u003cp>Despite multiple attempts by Congressional Republicans each year to repeal ACA — also known as Obamacare — marketplaces have only grown since the health care law passed in 2010. “There was talk that when the Affordable Care Act launched, insurers would not buy in because it wouldn’t be a profitable enterprise for them,” Becerra said.\u003c/p>\n\u003cp>“Well, they’re in. Now what’s happening is they’re offering a panoply of plans; it’s tough to figure out which one is good for you,” he added.\u003c/p>\n\u003cp>“So we’re going to move more towards requiring the plans [to] provide some standardization, so people can make some good guesses about what might be good for them,” Becerra said.\u003c/p>\n\u003cp>\u003c/p>\n\u003c/div>\u003c/p>",
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"slug": "layoffs-unemployment-benefits-health-insurance-calfresh",
"title": "What to Do After a Layoff: Unemployment, Health Insurance, and Other Benefits",
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"content": "\u003cp>\u003cem>This guide is part of the KQED News series \u003cstrong>\u003ca href=\"https://www.kqed.org/news/tag/what-to-do-after-a-layoff\">What to Do After a Layoff.\u003c/a>\u003c/strong>\u003c/em>\u003c/p>\n\u003cp>Knowing what to do when you get laid off can feel like a daunting prospect — especially if losing your job came as a total shock.\u003c/p>\n\u003cp>We’ve compiled a list of the initial steps to take after a layoff, to ensure you’re in as secure a place as possible. Jump straight to:\u003c/p>\n\u003cul>\n\u003cli>\u003cstrong>\u003ca href=\"#unemploymentbenefits\">Applying for unemployment benefits\u003c/a>\u003c/strong>\u003c/li>\n\u003cli>\u003cstrong>\u003ca href=\"#healthinsurance\">Keeping your health insurance\u003c/a>\u003c/strong>\u003c/li>\n\u003cli>\u003cstrong>\u003ca href=\"#otherbenefits\">Other benefits you might not know you’re eligible for\u003c/a>\u003c/strong>\u003c/li>\n\u003c/ul>\n\u003cp>… Or keep reading. As with the instructions for assembling furniture, you might find it helpful to read all this advice start to finish before you embark on these applications — to be prepared for any bumps you might encounter.\u003c/p>\n\u003ch2>Three tips to making applying for benefits after a layoff easier\u003c/h2>\n\u003cp>\u003cb>Your local government may have staff to help you do this\u003c/b>\u003c/p>\n\u003cp>Many cities and counties have their own offices, staff or programs specifically designed for people in your situation right now — which often have physical offices you can visit, or hotlines to call to ask a person your questions. These kinds of local resources can be particularly helpful in navigating the various benefits you could be entitled to, and aiding in the application processes.\u003c/p>\n\u003cp>Some offices, like the Department of Benefits and Family Support within \u003ca href=\"https://www.sfhsa.org/\">San Francisco’s Human Services Agency (SFHSA)\u003c/a>, can take your information in one central application and apply for those benefits on your behalf.\u003c/p>\n\u003cp>Having the help of a city staffer trained in these applications could save you a lot of time and stress, says Bart Ellison, program manager at SFHSA’s Workforce Development Division — not just because the process is streamlined, but because you’ll be able to ask these folks questions either in person or over the phone. It’s their job to help you — let them do it.\u003c/p>\n\u003cul>\n\u003cli>\u003cstrong>\u003ca href=\"#tellus\">Tell us: What else do you need information about right now?\u003c/a>\u003c/strong>\u003c/li>\n\u003c/ul>\n\u003cp>Your city or county may also have a program to help you find new employment, like \u003ca href=\"https://www.sfhsa.org/services/jobs/jobsnow\">SFHSA’s free JobsNOW! program\u003c/a>, which is open to San Francisco job seekers based on their income level, and matches job hunters with roles.\u003c/p>\n\u003cp>\u003ca href=\"https://www.cdss.ca.gov/county-offices\">Find your local social services office in this statewide list.\u003c/a>\u003c/p>\n\u003cp>\u003cb>Don’t feel weird about claiming the benefits you’re owed\u003c/b>\u003c/p>\n\u003cp>When it comes to claiming benefits after a layoff, Ellison wants to remind you that “we all pay for this through our taxes.”\u003c/p>\n\u003cp>“It’s great that if you don’t need it, it’s there. If you do need it, it’s there, and it should be accessed,” Ellison said. “There’s no shame in any of that.”\u003c/p>\n\u003cp>[aside postID=\"news_11957790,news_11970001,news_11967946,news_11968709\" label=\"COVID Resources and Explainers\"]A lot of people also just don’t know about the benefits they could be eligible for, says Ellison, or assume they won’t qualify.\u003c/p>\n\u003cp>He also says that some of the eligible job seekers he and his team work with in San Francisco might fear coming forward to apply if a member of their family is undocumented, because they think it will cause them problems. “We don’t get involved in any of that,” said Ellison. “They should never fear that situation.”\u003c/p>\n\u003cp>\u003cb>Try to be patient with how long the application process could take\u003c/b>\u003c/p>\n\u003cp>Ellison says he and his team “try not to ask a client for documents that we know we already have in the system” — but concedes that sometimes, this process will feel like providing endless documentation. The benefits you’re applying for can be a mix of federal and state funds, so unfortunately “it’s not just as simple as coming in and saying, ‘Hi, I’m Bart, could you sign me up?,’” said Ellison.\u003c/p>\n\u003cp>The more you can follow through with any documentation requests, hopefully the faster and smoother your application process will go. “And if you need more time or need help gathering stuff, that is what the eligibility staff are there for,” said Ellison. “They are there to \u003ci>help \u003c/i>you find some of these things. So you just need to kind of be your own advocate, and speak up.”\u003c/p>\n\u003cul>\n\u003cli>\u003cstrong>Read more layoff advice in our \u003ca href=\"https://www.kqed.org/news/tag/what-to-do-after-a-layoff\">What to Do After a Layoff \u003c/a>series\u003c/strong>\u003c/li>\n\u003c/ul>\n\u003ch2>\u003ca id=\"unemploymentbenefits\">\u003c/a>Step 1: Apply for unemployment benefits\u003c/h2>\n\u003cp>If you’ve been laid off, \u003ca href=\"https://edd.ca.gov/en/unemployment/apply/\">apply for unemployment insurance\u003c/a> (UI, also known just as “unemployment”) from the California Employment Development Department (EDD) as soon as you can. Not only could it take at least three weeks to receive any benefits payments from a successful claim, but your claim begins when you first apply for it — not the day you lose your job. So time is of the essence.\u003c/p>\n\u003cp>\u003cb>Who can claim unemployment benefits?\u003c/b>\u003c/p>\n\u003cp>If you’re reading this and you \u003ci>chose\u003c/i> to leave your job, you usually aren’t eligible to claim unemployment. The exception to this is if you quit your job for what EDD calls “good cause,” which can include unsafe working conditions or a doctor’s advice. Whether or not you’re eligible to still claim UI in this situation will be determined by a phone interview with an EDD representative.\u003c/p>\n\u003cp>When applying for UI, you’ll have to show EDD that you have earned enough wages during the base period of 12 months, are totally or partially unemployed, are “unemployed through no fault of your own,” are physically able to work, are available for work and are ready and willing to accept work immediately.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>EDD will also ask you to show that you are “in satisfactory immigration status and authorized to work in the United States” not only now, but when you were earning the wages you’re using to establish your claim. EDD also warns that it will verify your immigration status and work authorization through the Department of Homeland Security.\u003c/p>\n\u003cp>You can \u003ca href=\"https://edd.ca.gov/en/unemployment/UI-Calculator/\">calculate the amount of unemployment benefits you can receive using this tool\u003c/a>. Remember that the amount of unemployment you’ll receive is based on your wages over the last 18 months, calculated by EDD from a base period of 12 months within that time — and if you didn’t earn any wages during that period, you won’t qualify for unemployment benefits.\u003c/p>\n\u003cp>\u003ca href=\"https://edd.ca.gov/en/unemployment/FAQ_-_Eligibility/\">See the EDD’s FAQ on who’s eligible to claim unemployment insurance.\u003c/a>\u003c/p>\n\u003cp>\u003cb>Gather your application information\u003c/b>\u003c/p>\n\u003cp>During your online application for UI, you’ll be asked to submit a lot of information — and it’s easiest to have all that gathered and ready, rather than trying to track it down in the middle of the process.\u003c/p>\n\u003cp>In addition to your basic identity information, you’ll need:\u003c/p>\n\u003cul>\n\u003cli>Your Social Security number\u003c/li>\n\u003cli>Your employment authorization information, if you’re not a U.S. citizen\u003c/li>\n\u003cli>A photo ID like a passport or driver’s license (for your ID.me account — more below)\u003c/li>\n\u003c/ul>\n\u003cp>You’ll also need to provide your employment history for the last 18 months, which will include:\u003c/p>\n\u003cul>\n\u003cli>The names of your previous employers\u003c/li>\n\u003cli>Their addresses\u003c/li>\n\u003cli>Their phone numbers\u003c/li>\n\u003cli>The reason each job ended\u003c/li>\n\u003cli>Your gross (total) wages earned\u003c/li>\n\u003cli>Hours worked per week\u003c/li>\n\u003cli>Hourly rate of pay\u003c/li>\n\u003c/ul>\n\u003cfigure id=\"attachment_11946480\" class=\"wp-caption alignnone\" style=\"max-width: 2560px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11946480 size-full\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/04/GettyImages-1400799758-scaled.jpg\" alt=\"A woman sits at her kitchen table and sifts through documents, looking concerned. Next to her is her opened laptop.\" width=\"2560\" height=\"1708\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/04/GettyImages-1400799758-scaled.jpg 2560w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/04/GettyImages-1400799758-800x534.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/04/GettyImages-1400799758-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/04/GettyImages-1400799758-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/04/GettyImages-1400799758-1536x1025.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/04/GettyImages-1400799758-2048x1366.jpg 2048w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/04/GettyImages-1400799758-1920x1281.jpg 1920w\" sizes=\"auto, (max-width: 2560px) 100vw, 2560px\">\u003cfigcaption class=\"wp-caption-text\">During your online application for UI, you’ll be asked to submit a lot of information — and it’s easiest to have all that gathered and ready, rather than trying to track it down in the middle of the process. \u003ccite>(MoMo Productions/Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cb>Make the online accounts you’ll need to apply \u003c/b>\u003c/p>\n\u003cp>To apply for UI for the first time, you’ll need to \u003ca href=\"https://portal.edd.ca.gov/WebApp/Registration\">create a new Benefit Programs Online account\u003c/a>, to enable you to log in and manage your UI claim. (You may already have one of these accounts if you’ve previously applied for UI, disability insurance or paid family leave — in that case, use the same one.)\u003c/p>\n\u003cp>When you give an email address as part of your Benefit Programs Online application, make sure you check for any emails from EDD. When you get an email with a link to complete your registration, make sure you click that link within 48 hours of receiving it — otherwise, you’ll have to start the registration process all over again.\u003c/p>\n\u003cp>When you’ve created your Benefit Programs Online account, \u003ca href=\"https://edd.ca.gov/en/unemployment/ui_online/\">you’ll then register for UI Online\u003c/a>, which is the part of EDD’s online services that allows you to claim and manage your unemployment benefits. Keep reading for how to file your first UI claim.\u003c/p>\n\u003cp>You’ll \u003ci>also\u003c/i> need to \u003ca href=\"https://help.id.me/hc/en-us/articles/202673924-Creating-your-ID-me-account\">have an account with ID.me\u003c/a>, the identity verification EDD uses to make sure you’re really you when you’re claiming benefits. You can create your ID.me account before you create your Benefit Programs Online account, or when prompted during the process of creating it. If you’re creating your ID.me account beforehand, just make sure you keep the login details on hand so that you can sign into ID.me when prompted.\u003c/p>\n\u003cp>You might consider watching the \u003ca href=\"https://www.youtube.com/watch?v=moJ1mokMRgc\">EDD’s short instructional video on YouTube about creating these accounts and filing your first UI claim\u003c/a>, so you know what to expect during the process.\u003c/p>\n\u003cp>\u003cb>File your new UI claim\u003c/b>\u003c/p>\n\u003cp>One big thing: To start using UI Online, you’ll be asked for your “EDD Customer Account Number.” This is a number that’s unique to you, that you can also give instead of your Social Security number on the phone when speaking with an EDD representative. You should receive this number at the preferred email address you gave to EDD — in which case you can start using that EDD Customer Account Number immediately to register for UI Online. It’s also possible to \u003ca href=\"https://edd.ca.gov/en/unemployment/create-account/\">receive this number via mail “10 days after you file your claim,” says EDD\u003c/a>.\u003c/p>\n\u003cp>To file a new claim, \u003ca href=\"https://portal.edd.ca.gov/WebApp/Login?resource_url=https:%2F%2Fportal.edd.ca.gov%2FWebApp%2FHome\">log into your Benefit Programs Online account\u003c/a>, and under “UI Online” select “File New Claim.” Remember you’ll also be asked to briefly sign in to your ID.me account to verify your identity.\u003c/p>\n\u003cp>You can’t apply with UI Online 24/7, unfortunately — \u003ca href=\"https://edd.ca.gov/en/unemployment/ui_online/\">the site has hours of operation\u003c/a> (located on the File and Manage Account tab), which EDD says are currently (all times Pacific Standard Time):\u003c/p>\n\u003cul>\n\u003cli>Sunday: 5 a.m.–8:30 p.m.\u003c/li>\n\u003cli>Monday: 4 a.m.–10 p.m.\u003c/li>\n\u003cli>Tuesday–Friday: 2 a.m.–10 p.m.\u003c/li>\n\u003cli>Saturday: 2 a.m.–8 p.m.\u003c/li>\n\u003c/ul>\n\u003cp>If you need to pause during the UI Online application process, you can hit “Save as draft” to save your application to return to later — unless it’s \u003ci>after \u003c/i>8 p.m. on the Saturday of the week you’ve started the application. If it’s after 8 p.m. on Saturday, or you’re doing this on a Sunday, you won’t be able to save your application, and you will have to start it all over again if you exit.\u003c/p>\n\u003cp>If you’re having issues with UI Online, \u003ca href=\"https://edd.ca.gov/en/unemployment/ui_online/\">EDD recommends that you call their help line\u003c/a> at (833) 978-2511 and select option 1 after the introduction, available 8 a.m.–5 p.m., Monday through Friday. EDD says that Monday morning before 10 a.m. is their busiest call time.\u003c/p>\n\u003cp>\u003cb>Getting — and keeping — your unemployment benefits\u003c/b>\u003c/p>\n\u003cp>Once your application is complete, be aware of \u003ca href=\"https://edd.ca.gov/en/unemployment/After_You_Filed/\">the next steps and further information that EDD will ask of you\u003c/a>.\u003c/p>\n\u003cp>EDD says that \u003ca href=\"https://edd.ca.gov/en/unemployment/After_You_Filed/\">it “takes at least three weeks to process a claim\u003c/a> for unemployment benefits and issue payment to most eligible workers.” You’ll receive a debit card in the mail, which you can activate and then use to access your payments. If you have an old debit card from a previous UI claim, you can still use that one unless it’s expired (in which case you’ll be sent a new one).\u003c/p>\n\u003cp>To keep receiving UI after you first apply, you’ll have to certify for your unemployment benefits again every two weeks to continue receiving payments. You can do this online, by phone or through the mail, but EDD says you’ll get your payments faster if you certify online — and you’ll also get email reminders this way.\u003c/p>\n\u003cp>As part of this certification process every two weeks, you’ll have to \u003ca href=\"https://www.youtube.com/watch?v=3t_RgeoPH_g\">attest that you’re actively seeking employment\u003c/a>. This requirement was paused during the pandemic, but has since been reinstated. You’ll also need to \u003ca href=\"https://edd.ca.gov/en/jobs_and_training/Caljobs/\">register for CalJOBS and post your resume to the site\u003c/a> to keep receiving your UI benefits.\u003c/p>\n\u003cp>If you start doing any work again after losing your job, it’s very important that you report those earnings when you certify for your UI benefits — because those wages have to be deducted from your unemployment benefits. \u003ca href=\"https://edd.ca.gov/en/unemployment/FAQ-claims/#:~:text=Can%20I%20still%20collect%20benefits,deducted%20from%20your%20unemployment%20payments.\">Read more on how EDD will adjust your UI if you start earning money again while claiming unemployment benefits.\u003c/a>\u003c/p>\n\u003cp>And if you’re lucky enough to find a new full-time job, EDD is clear: “If you return to work full time, you will no longer be eligible for unemployment benefits.”\u003c/p>\n\u003cp>\u003ca href=\"https://edd.ca.gov/en/unemployment/certify/\">See EDD’s FAQ on certifying your UI claim every two weeks.\u003c/a>\u003c/p>\n\u003ch2>\u003ca id=\"healthinsurance\">\u003c/a>Step 2: Address your health insurance\u003c/h2>\n\u003cp>If your health insurance was tied to your employment, you need to act swiftly to ensure you’ll still have access to health care after your job ends. The option that’s best for you after your employment ends will depend primarily on how much income your household will now be receiving after you stop working.\u003c/p>\n\u003cp>Remember that if you’ve applied for unemployment benefits, \u003ca href=\"https://www.healthcare.gov/unemployed/\">you’ll need to declare that unemployment compensation as income\u003c/a> when applying for health insurance plans. \u003ca href=\"https://www.healthcare.gov/income-and-household-information/income/\">Get advice on how to estimate your income on your application.\u003c/a>\u003c/p>\n\u003cp>\u003cb>First, check with your employer on when your health benefits will \u003ci>actually\u003c/i> end.\u003c/b>\u003c/p>\n\u003cp>Sometimes a severance package will offer a holdover of benefits, advises the San Francisco’s Human Services Agency’s Bart Ellison. Ask very specific questions of your human resources team, if you have one, about when the last day of your health care will be.\u003c/p>\n\u003cp>\u003cb>See if you can go on a family member’s health care.\u003c/b>\u003c/p>\n\u003cp>Losing your health care because of a job loss will likely qualify as a special enrollment period for joining a family member’s plan, if eligible.\u003c/p>\n\u003cp>If you have a domestic partner, you may be eligible to join their plan. If you’re under 26 years old, \u003ca href=\"https://www.healthcare.gov/young-adults/children-under-26/\">you may be able to join a parent’s plan\u003c/a>.\u003c/p>\n\u003cfigure id=\"attachment_11945872\" class=\"wp-caption alignnone\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11945872 size-full\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/04/pexels-cottonbro-studio-4778412.jpg\" alt=\"A person with medium-toned skin sits at a wooden table writing on a notepad, surrounded by books. They are wearing a gray t-shirt and have tattooed forearms. We can't see their face.\" width=\"1920\" height=\"1280\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/04/pexels-cottonbro-studio-4778412.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/04/pexels-cottonbro-studio-4778412-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/04/pexels-cottonbro-studio-4778412-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/04/pexels-cottonbro-studio-4778412-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/04/pexels-cottonbro-studio-4778412-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Applying for benefits you’re entitled to can be a time-consuming process. \u003ccite>(cottonbro studio/Pexels)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cb>Medi-Cal\u003c/b>\u003c/p>\n\u003cp>Medi-Cal is California’s version of Medicaid, which offers health care to lower-income folks throughout the state. Eligibility is assessed by your household income, and for many people who qualify, there is no cost of getting health care through Medi-Cal.\u003c/p>\n\u003cp>Laws passed in the last few years in California mean that \u003ca href=\"https://www.dhcs.ca.gov/services/medi-cal/eligibility/Pages/youngadultexp.aspx\">undocumented people age 25 or under\u003c/a> and also \u003ca href=\"https://www.dhcs.ca.gov/services/medi-cal/eligibility/Pages/OlderAdultExpansion.aspx\">undocumented adults age 50 and over\u003c/a> are now eligible to receive Medi-Cal, too.\u003c/p>\n\u003cp>Unlike Covered California, \u003ca href=\"https://www.healthcare.gov/unemployed/\">Medi-Cal has no limited enrollment period\u003c/a> — you can sign up at any time of year if eligible, including if you’ve lost your job. If your children previously were getting health care through your employer’s plan, \u003ca href=\"https://www.insurekidsnow.gov/coverage/ca/index.html\">Medi-Cal — or the Children’s Health Insurance Program — may be able to cover them now\u003c/a>.\u003c/p>\n\u003cp>\u003ca href=\"https://www.dhcs.ca.gov/services/medi-cal/eligibility/Pages/Medi-CalFAQs2014a.aspx#1\">See the state’s FAQ about Medi-Cal.\u003c/a> Medi-Cal and Covered California use the same application portal at \u003ca href=\"https://www.coveredca.com/apply/\">coveredca.com/apply\u003c/a>. Fill out your details, and the site will tell you whether your household income makes you eligible for Medi-Cal or whether you have to choose a private plan from Covered California.\u003c/p>\n\u003cp>\u003cb>Covered California\u003c/b>\u003c/p>\n\u003cp>Covered California is the state’s marketplace that offers private health insurance plans. Depending on your household income, you may qualify for a free or low-cost health plan through Covered California — or you may be eligible to receive financial help through Covered California that could help cover the costs of your premiums and co-pays. As with Medi-Cal, your household income is going to determine what you’re eligible for.\u003c/p>\n\u003cp>Leaving your job for any reason and subsequently \u003ca href=\"https://www.healthcare.gov/unemployed/\">losing your job-based health coverage qualifies for a special enrollment period\u003c/a> for signing up for a marketplace health plan. Usually, you’ll get 60 days from the day you lose your coverage to sign up for a health plan.\u003c/p>\n\u003cp>\u003ca href=\"https://www.dhcs.ca.gov/services/medi-cal/eligibility/Pages/Medi-CalFAQs2014c.aspx#1\">See the state’s FAQ about Covered California.\u003c/a> Remember, Covered California uses the same application portal as Medi-Cal at \u003ca href=\"https://www.coveredca.com/apply/\">coveredca.com/apply\u003c/a>. Fill out your details, and the site will tell you whether your household income makes you eligible for Medi-Cal or whether you have to choose a private plan from Covered California.\u003c/p>\n\u003cp>\u003cb>COBRA\u003c/b>\u003c/p>\n\u003cp>COBRA stands for the federal Consolidated Omnibus Budget Reconciliation Act — and it’s a way of temporarily keeping health care after you leave a job. Instead of opting to sign up for Medi-Cal or a private health insurance plan through Covered California, you can choose so-called “continuation coverage” of your existing health care plan under COBRA, for a certain period of time.\u003c/p>\n\u003cp>\u003ca href=\"https://www.cms.gov/CCIIO/Programs-and-Initiatives/Other-Insurance-Protections/cobra_qna\">Health care through COBRA can be applied retroactively\u003c/a>, if you’re unsure about electing it straightaway. The catch: COBRA is expensive, because it’s the health plan your employer was previously paying part or all of — and now, you’re paying all the costs yourself.\u003c/p>\n\u003cp>\u003cb>Getting back onto health insurance taking a while? Know where your nearest community health center is.\u003c/b>\u003c/p>\n\u003cp>If you aren’t eligible for coverage through Medi-Cal, but signing up for another health plan is proving challenging right now, you can get low-cost health care at a nearby community health center. Make sure you know where your nearest one is, in case you need access to health care quickly. You can \u003ca href=\"https://findahealthcenter.hrsa.gov/\">use this map to find the closest community health center near you\u003c/a>.\u003c/p>\n\u003cp>\u003cb>More resources on finding health care after losing your job:\u003c/b>\u003c/p>\n\u003cul>\n\u003cli>“\u003ca href=\"https://www.coveredca.com/marketing-blog/health-insurance-for-the-unemployed-from-cobra-to-medi-cal/\">Health Insurance for the Unemployed, from COBRA to Medi-Cal\u003c/a>” (from coveredca.com)\u003c/li>\n\u003cli>“\u003ca href=\"https://www.healthcare.gov/unemployed/\">Health coverage options if you’re unemployed\u003c/a>” (from healthcare.gov)\u003c/li>\n\u003c/ul>\n\u003ch2>\u003ca id=\"otherbenefits\">\u003c/a>Step 3: Don’t forget about other benefits you could be entitled to\u003c/h2>\n\u003cp>The quickest way to see what benefits you might be eligible for now is to \u003ca href=\"https://benefitscal.com/ApplyForBenefits/ABOVR\">do one application through the state’s BenefitsCal portal\u003c/a>. This site will review your information and tell you what you may qualify for, including Medi-Cal.\u003c/p>\n\u003cp>The state says this application will take you between 30 minutes and an hour, and if you make an account you can save your progress and return to the application later, rather than having to start again. One catch: Not all counties in California are using this portal yet. \u003ca href=\"https://benefitscal.com/ApplyForBenefits/ABOVR\">Select your county from the drop-down menu\u003c/a> to see whether you have to use another site — \u003ca href=\"https://www.mybenefitscalwin.org/\">mybenefitscalwin.org\u003c/a> — instead.\u003c/p>\n\u003cp>The other benefits you could be entitled to may include:\u003c/p>\n\u003cp>\u003cb>CalFresh (SNAP)\u003c/b>\u003c/p>\n\u003cp>CalFresh is the state’s version of the federal Supplemental Nutrition Assistance Program (SNAP), the food benefits program also known as “food stamps.”\u003c/p>\n\u003cp>[aside postID=\"news_11943420\" hero=\"https://ww2.kqed.org/app/uploads/sites/10/2023/03/GettyImages-1144627849-1020x680.jpg\"]According to the state’s data from March 2023, over 3 million households use these funds to ensure they have access to food. You can \u003ca href=\"https://benefitscal.com/ApplyForBenefits/ABOVR\">apply through benefitscal.com\u003c/a>, which will also show you all other benefits you’re entitled to, or \u003ca href=\"https://www.getcalfresh.org/\">go direct through getcalfresh.org\u003c/a>.\u003c/p>\n\u003cp>\u003cb>CalWORKs (California Work Opportunity and Responsibility to Kids)\u003c/b>\u003c/p>\n\u003cp>If you have at least one child in your home, CalWORKs is a public assistance program that offers cash aid and services to eligible families. \u003ca href=\"https://benefitscal.com/\">See if your family is eligible to receive CalWORKs at benefitscal.com\u003c/a>.\u003c/p>\n\u003cp>\u003cb>WIC (Women, Infants and Children Supplemental Nutrition Program)\u003c/b>\u003c/p>\n\u003cp>WIC provides food assistance to lower-income families who have young children or are expecting a new child. Like CalFresh, it’s federally funded, and you can receive WIC benefits on top of your CalFresh benefits.\u003c/p>\n\u003cp>The program is income-based, and is available to pregnant people, plus new parents and grandparents of young children.\u003ca href=\"https://myfamily.wic.ca.gov/Home/HowCanIGetWIC#howToGetWIC\"> See whether you’re eligible for WIC and apply online.\u003c/a>\u003c/p>\n\u003cp>Make sure to read the rest of our KQED guides about other steps you can take after a layoff to better support yourself and those who depend on you:\u003c/p>\n\u003cul>\n\u003cli>\u003cstrong>\u003ca href=\"https://www.kqed.org/news/11949801/layoffs-how-to-find-a-new-job-jobhunting-tips\">The Best Ways to Find a New Job, According to an Expert\u003c/a>\u003c/strong>\u003c/li>\n\u003cli>\u003cstrong>\u003ca href=\"https://www.kqed.org/news/11949674/layoffs-mental-health-lost-job-self-care\">How to Prioritize Your Mental Health After Losing Your Job, From Telling Family to Self-Care\u003c/a>\u003c/strong>\u003c/li>\n\u003cli>\u003cstrong>\u003ca href=\"https://www.kqed.org/news/11948895/layoffs-how-to-save-more-money-after-losing-your-job\">How to Save More Money After Losing Your Job\u003c/a>\u003c/strong>\u003c/li>\n\u003c/ul>\n\u003ch2>\u003ca id=\"tellus\">\u003c/a>Tell us: What else do you need information about?\u003c/h2>\n\u003cp>At KQED News, we know that it can sometimes be hard to track down the answers to navigate life in the Bay Area. We’ve published \u003ca href=\"https://www.kqed.org/news/tag/coronavirus-resources-and-explainers\">clear, practical explainers and guides about COVID\u003c/a>, \u003ca href=\"https://www.kqed.org/news/11936674/how-to-prepare-for-this-weeks-atmospheric-river-storm-sandbags-emergency-kits-and-more\">how to cope with intense winter weather\u003c/a> and \u003ca href=\"https://www.kqed.org/news/11821950/how-to-safely-attend-a-protest-in-the-bay-area\">how to exercise your right to protest safely\u003c/a>.\u003c/p>\n\u003cp>So tell us: What do you need to know more about? Tell us, and you could see your question answered online or on social media. What you submit will make our reporting stronger, and help us decide what to cover here on our site, and on KQED Public Radio, too.\u003c/p>\n\u003cp>[hearken id=\"10483\" src=\"https://modules.wearehearken.com/kqed/embed/10483.js\"]\u003c/p>\n\u003cp>\u003cem>This story was originally published on May 19, 2023\u003c/em>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"excerpt": "Knowing what to do when you get laid off can feel daunting — especially if losing your job came as a shock. Check out our list of the initial steps to take after a layoff, to ensure you’re in as secure a place as possible.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cem>This guide is part of the KQED News series \u003cstrong>\u003ca href=\"https://www.kqed.org/news/tag/what-to-do-after-a-layoff\">What to Do After a Layoff.\u003c/a>\u003c/strong>\u003c/em>\u003c/p>\n\u003cp>Knowing what to do when you get laid off can feel like a daunting prospect — especially if losing your job came as a total shock.\u003c/p>\n\u003cp>We’ve compiled a list of the initial steps to take after a layoff, to ensure you’re in as secure a place as possible. Jump straight to:\u003c/p>\n\u003cul>\n\u003cli>\u003cstrong>\u003ca href=\"#unemploymentbenefits\">Applying for unemployment benefits\u003c/a>\u003c/strong>\u003c/li>\n\u003cli>\u003cstrong>\u003ca href=\"#healthinsurance\">Keeping your health insurance\u003c/a>\u003c/strong>\u003c/li>\n\u003cli>\u003cstrong>\u003ca href=\"#otherbenefits\">Other benefits you might not know you’re eligible for\u003c/a>\u003c/strong>\u003c/li>\n\u003c/ul>\n\u003cp>… Or keep reading. As with the instructions for assembling furniture, you might find it helpful to read all this advice start to finish before you embark on these applications — to be prepared for any bumps you might encounter.\u003c/p>\n\u003ch2>Three tips to making applying for benefits after a layoff easier\u003c/h2>\n\u003cp>\u003cb>Your local government may have staff to help you do this\u003c/b>\u003c/p>\n\u003cp>Many cities and counties have their own offices, staff or programs specifically designed for people in your situation right now — which often have physical offices you can visit, or hotlines to call to ask a person your questions. These kinds of local resources can be particularly helpful in navigating the various benefits you could be entitled to, and aiding in the application processes.\u003c/p>\n\u003cp>Some offices, like the Department of Benefits and Family Support within \u003ca href=\"https://www.sfhsa.org/\">San Francisco’s Human Services Agency (SFHSA)\u003c/a>, can take your information in one central application and apply for those benefits on your behalf.\u003c/p>\n\u003cp>Having the help of a city staffer trained in these applications could save you a lot of time and stress, says Bart Ellison, program manager at SFHSA’s Workforce Development Division — not just because the process is streamlined, but because you’ll be able to ask these folks questions either in person or over the phone. It’s their job to help you — let them do it.\u003c/p>\n\u003cul>\n\u003cli>\u003cstrong>\u003ca href=\"#tellus\">Tell us: What else do you need information about right now?\u003c/a>\u003c/strong>\u003c/li>\n\u003c/ul>\n\u003cp>Your city or county may also have a program to help you find new employment, like \u003ca href=\"https://www.sfhsa.org/services/jobs/jobsnow\">SFHSA’s free JobsNOW! program\u003c/a>, which is open to San Francisco job seekers based on their income level, and matches job hunters with roles.\u003c/p>\n\u003cp>\u003ca href=\"https://www.cdss.ca.gov/county-offices\">Find your local social services office in this statewide list.\u003c/a>\u003c/p>\n\u003cp>\u003cb>Don’t feel weird about claiming the benefits you’re owed\u003c/b>\u003c/p>\n\u003cp>When it comes to claiming benefits after a layoff, Ellison wants to remind you that “we all pay for this through our taxes.”\u003c/p>\n\u003cp>“It’s great that if you don’t need it, it’s there. If you do need it, it’s there, and it should be accessed,” Ellison said. “There’s no shame in any of that.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>A lot of people also just don’t know about the benefits they could be eligible for, says Ellison, or assume they won’t qualify.\u003c/p>\n\u003cp>He also says that some of the eligible job seekers he and his team work with in San Francisco might fear coming forward to apply if a member of their family is undocumented, because they think it will cause them problems. “We don’t get involved in any of that,” said Ellison. “They should never fear that situation.”\u003c/p>\n\u003cp>\u003cb>Try to be patient with how long the application process could take\u003c/b>\u003c/p>\n\u003cp>Ellison says he and his team “try not to ask a client for documents that we know we already have in the system” — but concedes that sometimes, this process will feel like providing endless documentation. The benefits you’re applying for can be a mix of federal and state funds, so unfortunately “it’s not just as simple as coming in and saying, ‘Hi, I’m Bart, could you sign me up?,’” said Ellison.\u003c/p>\n\u003cp>The more you can follow through with any documentation requests, hopefully the faster and smoother your application process will go. “And if you need more time or need help gathering stuff, that is what the eligibility staff are there for,” said Ellison. “They are there to \u003ci>help \u003c/i>you find some of these things. So you just need to kind of be your own advocate, and speak up.”\u003c/p>\n\u003cul>\n\u003cli>\u003cstrong>Read more layoff advice in our \u003ca href=\"https://www.kqed.org/news/tag/what-to-do-after-a-layoff\">What to Do After a Layoff \u003c/a>series\u003c/strong>\u003c/li>\n\u003c/ul>\n\u003ch2>\u003ca id=\"unemploymentbenefits\">\u003c/a>Step 1: Apply for unemployment benefits\u003c/h2>\n\u003cp>If you’ve been laid off, \u003ca href=\"https://edd.ca.gov/en/unemployment/apply/\">apply for unemployment insurance\u003c/a> (UI, also known just as “unemployment”) from the California Employment Development Department (EDD) as soon as you can. Not only could it take at least three weeks to receive any benefits payments from a successful claim, but your claim begins when you first apply for it — not the day you lose your job. So time is of the essence.\u003c/p>\n\u003cp>\u003cb>Who can claim unemployment benefits?\u003c/b>\u003c/p>\n\u003cp>If you’re reading this and you \u003ci>chose\u003c/i> to leave your job, you usually aren’t eligible to claim unemployment. The exception to this is if you quit your job for what EDD calls “good cause,” which can include unsafe working conditions or a doctor’s advice. Whether or not you’re eligible to still claim UI in this situation will be determined by a phone interview with an EDD representative.\u003c/p>\n\u003cp>When applying for UI, you’ll have to show EDD that you have earned enough wages during the base period of 12 months, are totally or partially unemployed, are “unemployed through no fault of your own,” are physically able to work, are available for work and are ready and willing to accept work immediately.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>EDD will also ask you to show that you are “in satisfactory immigration status and authorized to work in the United States” not only now, but when you were earning the wages you’re using to establish your claim. EDD also warns that it will verify your immigration status and work authorization through the Department of Homeland Security.\u003c/p>\n\u003cp>You can \u003ca href=\"https://edd.ca.gov/en/unemployment/UI-Calculator/\">calculate the amount of unemployment benefits you can receive using this tool\u003c/a>. Remember that the amount of unemployment you’ll receive is based on your wages over the last 18 months, calculated by EDD from a base period of 12 months within that time — and if you didn’t earn any wages during that period, you won’t qualify for unemployment benefits.\u003c/p>\n\u003cp>\u003ca href=\"https://edd.ca.gov/en/unemployment/FAQ_-_Eligibility/\">See the EDD’s FAQ on who’s eligible to claim unemployment insurance.\u003c/a>\u003c/p>\n\u003cp>\u003cb>Gather your application information\u003c/b>\u003c/p>\n\u003cp>During your online application for UI, you’ll be asked to submit a lot of information — and it’s easiest to have all that gathered and ready, rather than trying to track it down in the middle of the process.\u003c/p>\n\u003cp>In addition to your basic identity information, you’ll need:\u003c/p>\n\u003cul>\n\u003cli>Your Social Security number\u003c/li>\n\u003cli>Your employment authorization information, if you’re not a U.S. citizen\u003c/li>\n\u003cli>A photo ID like a passport or driver’s license (for your ID.me account — more below)\u003c/li>\n\u003c/ul>\n\u003cp>You’ll also need to provide your employment history for the last 18 months, which will include:\u003c/p>\n\u003cul>\n\u003cli>The names of your previous employers\u003c/li>\n\u003cli>Their addresses\u003c/li>\n\u003cli>Their phone numbers\u003c/li>\n\u003cli>The reason each job ended\u003c/li>\n\u003cli>Your gross (total) wages earned\u003c/li>\n\u003cli>Hours worked per week\u003c/li>\n\u003cli>Hourly rate of pay\u003c/li>\n\u003c/ul>\n\u003cfigure id=\"attachment_11946480\" class=\"wp-caption alignnone\" style=\"max-width: 2560px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11946480 size-full\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/04/GettyImages-1400799758-scaled.jpg\" alt=\"A woman sits at her kitchen table and sifts through documents, looking concerned. Next to her is her opened laptop.\" width=\"2560\" height=\"1708\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/04/GettyImages-1400799758-scaled.jpg 2560w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/04/GettyImages-1400799758-800x534.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/04/GettyImages-1400799758-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/04/GettyImages-1400799758-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/04/GettyImages-1400799758-1536x1025.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/04/GettyImages-1400799758-2048x1366.jpg 2048w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/04/GettyImages-1400799758-1920x1281.jpg 1920w\" sizes=\"auto, (max-width: 2560px) 100vw, 2560px\">\u003cfigcaption class=\"wp-caption-text\">During your online application for UI, you’ll be asked to submit a lot of information — and it’s easiest to have all that gathered and ready, rather than trying to track it down in the middle of the process. \u003ccite>(MoMo Productions/Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cb>Make the online accounts you’ll need to apply \u003c/b>\u003c/p>\n\u003cp>To apply for UI for the first time, you’ll need to \u003ca href=\"https://portal.edd.ca.gov/WebApp/Registration\">create a new Benefit Programs Online account\u003c/a>, to enable you to log in and manage your UI claim. (You may already have one of these accounts if you’ve previously applied for UI, disability insurance or paid family leave — in that case, use the same one.)\u003c/p>\n\u003cp>When you give an email address as part of your Benefit Programs Online application, make sure you check for any emails from EDD. When you get an email with a link to complete your registration, make sure you click that link within 48 hours of receiving it — otherwise, you’ll have to start the registration process all over again.\u003c/p>\n\u003cp>When you’ve created your Benefit Programs Online account, \u003ca href=\"https://edd.ca.gov/en/unemployment/ui_online/\">you’ll then register for UI Online\u003c/a>, which is the part of EDD’s online services that allows you to claim and manage your unemployment benefits. Keep reading for how to file your first UI claim.\u003c/p>\n\u003cp>You’ll \u003ci>also\u003c/i> need to \u003ca href=\"https://help.id.me/hc/en-us/articles/202673924-Creating-your-ID-me-account\">have an account with ID.me\u003c/a>, the identity verification EDD uses to make sure you’re really you when you’re claiming benefits. You can create your ID.me account before you create your Benefit Programs Online account, or when prompted during the process of creating it. If you’re creating your ID.me account beforehand, just make sure you keep the login details on hand so that you can sign into ID.me when prompted.\u003c/p>\n\u003cp>You might consider watching the \u003ca href=\"https://www.youtube.com/watch?v=moJ1mokMRgc\">EDD’s short instructional video on YouTube about creating these accounts and filing your first UI claim\u003c/a>, so you know what to expect during the process.\u003c/p>\n\u003cp>\u003cb>File your new UI claim\u003c/b>\u003c/p>\n\u003cp>One big thing: To start using UI Online, you’ll be asked for your “EDD Customer Account Number.” This is a number that’s unique to you, that you can also give instead of your Social Security number on the phone when speaking with an EDD representative. You should receive this number at the preferred email address you gave to EDD — in which case you can start using that EDD Customer Account Number immediately to register for UI Online. It’s also possible to \u003ca href=\"https://edd.ca.gov/en/unemployment/create-account/\">receive this number via mail “10 days after you file your claim,” says EDD\u003c/a>.\u003c/p>\n\u003cp>To file a new claim, \u003ca href=\"https://portal.edd.ca.gov/WebApp/Login?resource_url=https:%2F%2Fportal.edd.ca.gov%2FWebApp%2FHome\">log into your Benefit Programs Online account\u003c/a>, and under “UI Online” select “File New Claim.” Remember you’ll also be asked to briefly sign in to your ID.me account to verify your identity.\u003c/p>\n\u003cp>You can’t apply with UI Online 24/7, unfortunately — \u003ca href=\"https://edd.ca.gov/en/unemployment/ui_online/\">the site has hours of operation\u003c/a> (located on the File and Manage Account tab), which EDD says are currently (all times Pacific Standard Time):\u003c/p>\n\u003cul>\n\u003cli>Sunday: 5 a.m.–8:30 p.m.\u003c/li>\n\u003cli>Monday: 4 a.m.–10 p.m.\u003c/li>\n\u003cli>Tuesday–Friday: 2 a.m.–10 p.m.\u003c/li>\n\u003cli>Saturday: 2 a.m.–8 p.m.\u003c/li>\n\u003c/ul>\n\u003cp>If you need to pause during the UI Online application process, you can hit “Save as draft” to save your application to return to later — unless it’s \u003ci>after \u003c/i>8 p.m. on the Saturday of the week you’ve started the application. If it’s after 8 p.m. on Saturday, or you’re doing this on a Sunday, you won’t be able to save your application, and you will have to start it all over again if you exit.\u003c/p>\n\u003cp>If you’re having issues with UI Online, \u003ca href=\"https://edd.ca.gov/en/unemployment/ui_online/\">EDD recommends that you call their help line\u003c/a> at (833) 978-2511 and select option 1 after the introduction, available 8 a.m.–5 p.m., Monday through Friday. EDD says that Monday morning before 10 a.m. is their busiest call time.\u003c/p>\n\u003cp>\u003cb>Getting — and keeping — your unemployment benefits\u003c/b>\u003c/p>\n\u003cp>Once your application is complete, be aware of \u003ca href=\"https://edd.ca.gov/en/unemployment/After_You_Filed/\">the next steps and further information that EDD will ask of you\u003c/a>.\u003c/p>\n\u003cp>EDD says that \u003ca href=\"https://edd.ca.gov/en/unemployment/After_You_Filed/\">it “takes at least three weeks to process a claim\u003c/a> for unemployment benefits and issue payment to most eligible workers.” You’ll receive a debit card in the mail, which you can activate and then use to access your payments. If you have an old debit card from a previous UI claim, you can still use that one unless it’s expired (in which case you’ll be sent a new one).\u003c/p>\n\u003cp>To keep receiving UI after you first apply, you’ll have to certify for your unemployment benefits again every two weeks to continue receiving payments. You can do this online, by phone or through the mail, but EDD says you’ll get your payments faster if you certify online — and you’ll also get email reminders this way.\u003c/p>\n\u003cp>As part of this certification process every two weeks, you’ll have to \u003ca href=\"https://www.youtube.com/watch?v=3t_RgeoPH_g\">attest that you’re actively seeking employment\u003c/a>. This requirement was paused during the pandemic, but has since been reinstated. You’ll also need to \u003ca href=\"https://edd.ca.gov/en/jobs_and_training/Caljobs/\">register for CalJOBS and post your resume to the site\u003c/a> to keep receiving your UI benefits.\u003c/p>\n\u003cp>If you start doing any work again after losing your job, it’s very important that you report those earnings when you certify for your UI benefits — because those wages have to be deducted from your unemployment benefits. \u003ca href=\"https://edd.ca.gov/en/unemployment/FAQ-claims/#:~:text=Can%20I%20still%20collect%20benefits,deducted%20from%20your%20unemployment%20payments.\">Read more on how EDD will adjust your UI if you start earning money again while claiming unemployment benefits.\u003c/a>\u003c/p>\n\u003cp>And if you’re lucky enough to find a new full-time job, EDD is clear: “If you return to work full time, you will no longer be eligible for unemployment benefits.”\u003c/p>\n\u003cp>\u003ca href=\"https://edd.ca.gov/en/unemployment/certify/\">See EDD’s FAQ on certifying your UI claim every two weeks.\u003c/a>\u003c/p>\n\u003ch2>\u003ca id=\"healthinsurance\">\u003c/a>Step 2: Address your health insurance\u003c/h2>\n\u003cp>If your health insurance was tied to your employment, you need to act swiftly to ensure you’ll still have access to health care after your job ends. The option that’s best for you after your employment ends will depend primarily on how much income your household will now be receiving after you stop working.\u003c/p>\n\u003cp>Remember that if you’ve applied for unemployment benefits, \u003ca href=\"https://www.healthcare.gov/unemployed/\">you’ll need to declare that unemployment compensation as income\u003c/a> when applying for health insurance plans. \u003ca href=\"https://www.healthcare.gov/income-and-household-information/income/\">Get advice on how to estimate your income on your application.\u003c/a>\u003c/p>\n\u003cp>\u003cb>First, check with your employer on when your health benefits will \u003ci>actually\u003c/i> end.\u003c/b>\u003c/p>\n\u003cp>Sometimes a severance package will offer a holdover of benefits, advises the San Francisco’s Human Services Agency’s Bart Ellison. Ask very specific questions of your human resources team, if you have one, about when the last day of your health care will be.\u003c/p>\n\u003cp>\u003cb>See if you can go on a family member’s health care.\u003c/b>\u003c/p>\n\u003cp>Losing your health care because of a job loss will likely qualify as a special enrollment period for joining a family member’s plan, if eligible.\u003c/p>\n\u003cp>If you have a domestic partner, you may be eligible to join their plan. If you’re under 26 years old, \u003ca href=\"https://www.healthcare.gov/young-adults/children-under-26/\">you may be able to join a parent’s plan\u003c/a>.\u003c/p>\n\u003cfigure id=\"attachment_11945872\" class=\"wp-caption alignnone\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11945872 size-full\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/04/pexels-cottonbro-studio-4778412.jpg\" alt=\"A person with medium-toned skin sits at a wooden table writing on a notepad, surrounded by books. They are wearing a gray t-shirt and have tattooed forearms. We can't see their face.\" width=\"1920\" height=\"1280\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/04/pexels-cottonbro-studio-4778412.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/04/pexels-cottonbro-studio-4778412-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/04/pexels-cottonbro-studio-4778412-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/04/pexels-cottonbro-studio-4778412-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/04/pexels-cottonbro-studio-4778412-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Applying for benefits you’re entitled to can be a time-consuming process. \u003ccite>(cottonbro studio/Pexels)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cb>Medi-Cal\u003c/b>\u003c/p>\n\u003cp>Medi-Cal is California’s version of Medicaid, which offers health care to lower-income folks throughout the state. Eligibility is assessed by your household income, and for many people who qualify, there is no cost of getting health care through Medi-Cal.\u003c/p>\n\u003cp>Laws passed in the last few years in California mean that \u003ca href=\"https://www.dhcs.ca.gov/services/medi-cal/eligibility/Pages/youngadultexp.aspx\">undocumented people age 25 or under\u003c/a> and also \u003ca href=\"https://www.dhcs.ca.gov/services/medi-cal/eligibility/Pages/OlderAdultExpansion.aspx\">undocumented adults age 50 and over\u003c/a> are now eligible to receive Medi-Cal, too.\u003c/p>\n\u003cp>Unlike Covered California, \u003ca href=\"https://www.healthcare.gov/unemployed/\">Medi-Cal has no limited enrollment period\u003c/a> — you can sign up at any time of year if eligible, including if you’ve lost your job. If your children previously were getting health care through your employer’s plan, \u003ca href=\"https://www.insurekidsnow.gov/coverage/ca/index.html\">Medi-Cal — or the Children’s Health Insurance Program — may be able to cover them now\u003c/a>.\u003c/p>\n\u003cp>\u003ca href=\"https://www.dhcs.ca.gov/services/medi-cal/eligibility/Pages/Medi-CalFAQs2014a.aspx#1\">See the state’s FAQ about Medi-Cal.\u003c/a> Medi-Cal and Covered California use the same application portal at \u003ca href=\"https://www.coveredca.com/apply/\">coveredca.com/apply\u003c/a>. Fill out your details, and the site will tell you whether your household income makes you eligible for Medi-Cal or whether you have to choose a private plan from Covered California.\u003c/p>\n\u003cp>\u003cb>Covered California\u003c/b>\u003c/p>\n\u003cp>Covered California is the state’s marketplace that offers private health insurance plans. Depending on your household income, you may qualify for a free or low-cost health plan through Covered California — or you may be eligible to receive financial help through Covered California that could help cover the costs of your premiums and co-pays. As with Medi-Cal, your household income is going to determine what you’re eligible for.\u003c/p>\n\u003cp>Leaving your job for any reason and subsequently \u003ca href=\"https://www.healthcare.gov/unemployed/\">losing your job-based health coverage qualifies for a special enrollment period\u003c/a> for signing up for a marketplace health plan. Usually, you’ll get 60 days from the day you lose your coverage to sign up for a health plan.\u003c/p>\n\u003cp>\u003ca href=\"https://www.dhcs.ca.gov/services/medi-cal/eligibility/Pages/Medi-CalFAQs2014c.aspx#1\">See the state’s FAQ about Covered California.\u003c/a> Remember, Covered California uses the same application portal as Medi-Cal at \u003ca href=\"https://www.coveredca.com/apply/\">coveredca.com/apply\u003c/a>. Fill out your details, and the site will tell you whether your household income makes you eligible for Medi-Cal or whether you have to choose a private plan from Covered California.\u003c/p>\n\u003cp>\u003cb>COBRA\u003c/b>\u003c/p>\n\u003cp>COBRA stands for the federal Consolidated Omnibus Budget Reconciliation Act — and it’s a way of temporarily keeping health care after you leave a job. Instead of opting to sign up for Medi-Cal or a private health insurance plan through Covered California, you can choose so-called “continuation coverage” of your existing health care plan under COBRA, for a certain period of time.\u003c/p>\n\u003cp>\u003ca href=\"https://www.cms.gov/CCIIO/Programs-and-Initiatives/Other-Insurance-Protections/cobra_qna\">Health care through COBRA can be applied retroactively\u003c/a>, if you’re unsure about electing it straightaway. The catch: COBRA is expensive, because it’s the health plan your employer was previously paying part or all of — and now, you’re paying all the costs yourself.\u003c/p>\n\u003cp>\u003cb>Getting back onto health insurance taking a while? Know where your nearest community health center is.\u003c/b>\u003c/p>\n\u003cp>If you aren’t eligible for coverage through Medi-Cal, but signing up for another health plan is proving challenging right now, you can get low-cost health care at a nearby community health center. Make sure you know where your nearest one is, in case you need access to health care quickly. You can \u003ca href=\"https://findahealthcenter.hrsa.gov/\">use this map to find the closest community health center near you\u003c/a>.\u003c/p>\n\u003cp>\u003cb>More resources on finding health care after losing your job:\u003c/b>\u003c/p>\n\u003cul>\n\u003cli>“\u003ca href=\"https://www.coveredca.com/marketing-blog/health-insurance-for-the-unemployed-from-cobra-to-medi-cal/\">Health Insurance for the Unemployed, from COBRA to Medi-Cal\u003c/a>” (from coveredca.com)\u003c/li>\n\u003cli>“\u003ca href=\"https://www.healthcare.gov/unemployed/\">Health coverage options if you’re unemployed\u003c/a>” (from healthcare.gov)\u003c/li>\n\u003c/ul>\n\u003ch2>\u003ca id=\"otherbenefits\">\u003c/a>Step 3: Don’t forget about other benefits you could be entitled to\u003c/h2>\n\u003cp>The quickest way to see what benefits you might be eligible for now is to \u003ca href=\"https://benefitscal.com/ApplyForBenefits/ABOVR\">do one application through the state’s BenefitsCal portal\u003c/a>. This site will review your information and tell you what you may qualify for, including Medi-Cal.\u003c/p>\n\u003cp>The state says this application will take you between 30 minutes and an hour, and if you make an account you can save your progress and return to the application later, rather than having to start again. One catch: Not all counties in California are using this portal yet. \u003ca href=\"https://benefitscal.com/ApplyForBenefits/ABOVR\">Select your county from the drop-down menu\u003c/a> to see whether you have to use another site — \u003ca href=\"https://www.mybenefitscalwin.org/\">mybenefitscalwin.org\u003c/a> — instead.\u003c/p>\n\u003cp>The other benefits you could be entitled to may include:\u003c/p>\n\u003cp>\u003cb>CalFresh (SNAP)\u003c/b>\u003c/p>\n\u003cp>CalFresh is the state’s version of the federal Supplemental Nutrition Assistance Program (SNAP), the food benefits program also known as “food stamps.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>According to the state’s data from March 2023, over 3 million households use these funds to ensure they have access to food. You can \u003ca href=\"https://benefitscal.com/ApplyForBenefits/ABOVR\">apply through benefitscal.com\u003c/a>, which will also show you all other benefits you’re entitled to, or \u003ca href=\"https://www.getcalfresh.org/\">go direct through getcalfresh.org\u003c/a>.\u003c/p>\n\u003cp>\u003cb>CalWORKs (California Work Opportunity and Responsibility to Kids)\u003c/b>\u003c/p>\n\u003cp>If you have at least one child in your home, CalWORKs is a public assistance program that offers cash aid and services to eligible families. \u003ca href=\"https://benefitscal.com/\">See if your family is eligible to receive CalWORKs at benefitscal.com\u003c/a>.\u003c/p>\n\u003cp>\u003cb>WIC (Women, Infants and Children Supplemental Nutrition Program)\u003c/b>\u003c/p>\n\u003cp>WIC provides food assistance to lower-income families who have young children or are expecting a new child. Like CalFresh, it’s federally funded, and you can receive WIC benefits on top of your CalFresh benefits.\u003c/p>\n\u003cp>The program is income-based, and is available to pregnant people, plus new parents and grandparents of young children.\u003ca href=\"https://myfamily.wic.ca.gov/Home/HowCanIGetWIC#howToGetWIC\"> See whether you’re eligible for WIC and apply online.\u003c/a>\u003c/p>\n\u003cp>Make sure to read the rest of our KQED guides about other steps you can take after a layoff to better support yourself and those who depend on you:\u003c/p>\n\u003cul>\n\u003cli>\u003cstrong>\u003ca href=\"https://www.kqed.org/news/11949801/layoffs-how-to-find-a-new-job-jobhunting-tips\">The Best Ways to Find a New Job, According to an Expert\u003c/a>\u003c/strong>\u003c/li>\n\u003cli>\u003cstrong>\u003ca href=\"https://www.kqed.org/news/11949674/layoffs-mental-health-lost-job-self-care\">How to Prioritize Your Mental Health After Losing Your Job, From Telling Family to Self-Care\u003c/a>\u003c/strong>\u003c/li>\n\u003cli>\u003cstrong>\u003ca href=\"https://www.kqed.org/news/11948895/layoffs-how-to-save-more-money-after-losing-your-job\">How to Save More Money After Losing Your Job\u003c/a>\u003c/strong>\u003c/li>\n\u003c/ul>\n\u003ch2>\u003ca id=\"tellus\">\u003c/a>Tell us: What else do you need information about?\u003c/h2>\n\u003cp>At KQED News, we know that it can sometimes be hard to track down the answers to navigate life in the Bay Area. We’ve published \u003ca href=\"https://www.kqed.org/news/tag/coronavirus-resources-and-explainers\">clear, practical explainers and guides about COVID\u003c/a>, \u003ca href=\"https://www.kqed.org/news/11936674/how-to-prepare-for-this-weeks-atmospheric-river-storm-sandbags-emergency-kits-and-more\">how to cope with intense winter weather\u003c/a> and \u003ca href=\"https://www.kqed.org/news/11821950/how-to-safely-attend-a-protest-in-the-bay-area\">how to exercise your right to protest safely\u003c/a>.\u003c/p>\n\u003cp>So tell us: What do you need to know more about? Tell us, and you could see your question answered online or on social media. What you submit will make our reporting stronger, and help us decide what to cover here on our site, and on KQED Public Radio, too.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>This story was originally published on May 19, 2023\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>\u003cem>Lea este artículo en \u003ca href=\"https://calmatters.org/calmatters-en-espanol/2023/12/las-carisimas-facturas-por-uso-de-ambulancias-endeudaron-a-estas-familias-pero-una-nueva-ley-de-california-prohibe-la-practica/\">español\u003c/a>.\u003c/em>\u003c/p>\n\u003cp>The COVID-19 pandemic took a brutal toll on Danielle Miele’s family. But after two exorbitant ambulance bills, she’s now scared to call 911.\u003c/p>\n\u003cp>Her teenage son attempted suicide in 2022, Miele said. His mental health deteriorated during the pandemic, and he needed an ambulance transfer from the Roseville emergency room, where Miele took him to a treatment center in San Mateo. The ambulance company hit Miele with a $9,000 out-of-network charge, which was sent to collections “almost immediately,” she said.[pullquote align=\"right\" size=\"medium\" citation=\"Katie Van Deynze, Health Access California\"]‘It’s the last remaining gap, but it’s a really big one. You could be insured, but it doesn’t matter.’[/pullquote]The virus also left Miele with seizures that mimic the symptoms of a heart attack, she said. Miele called 911 the first time a seizure happened. The 15-minute ride to the hospital cost $4,000 without help from insurance, she said.\u003c/p>\n\u003cp>“The last time I had one of my seizures, I basically said, ‘I’m going to die here at home. … I’m not getting another ambulance,’” Miele said. “I’d maybe rather die at home than have more medical debt.”\u003c/p>\n\u003cp>A \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=202320240AB716\" target=\"_blank\" rel=\"noreferrer noopener\">new California law\u003c/a> that takes effect Jan. 1 targets the kind of “surprise” ambulance bills that put Miele’s family in debt, even though they had medical insurance. These bills take the form of out-of-network charges for privately insured patients without control over which ambulance company responds to a call for help.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Under the new law, patients will only have to pay the equivalent of what they would have paid for an in-network service. Health insurance and ambulance companies will have to settle the bill directly even if they don’t have an existing contract.\u003c/p>\n\u003cp>Supporters of the new law argue it will make a big difference for thousands of families like Miele’s. The second time that Miele’s son needed an emergency psychiatric hold, the ambulance company that arrived was part of the family’s insurance network. Their co-pay: $83.\u003c/p>\n\u003cp>Ambulance companies did not oppose the legislation, which includes guarantees that health insurance plans reimburse them for services.\u003c/p>\n\u003ch2>Millions in surprise bills\u003c/h2>\n\u003cp>The California Association of Health Plans, which represents insurers, opposed the bill before it became law because of its potential to increase premiums by $67.3 million statewide. In contrast, people with private health insurance stand to save approximately $44.5 million in \u003ca href=\"https://www.chbrp.org/sites/default/files/bill-documents/AB716/AB%20716%20Final.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">direct\u003c/a>\u003ca href=\"https://www.chbrp.org/sites/default/files/bill-documents/AB716/AB%20716%20Final.pdf\"> charges for ambulance rides\u003c/a>, according to a legislative analysis.\u003c/p>\n\u003cp>Katie Van Deynze, a legislative advocate for Health Access California, a consumer advocacy group that sponsored the legislation, said the law closes a longstanding gap in California’s \u003ca href=\"https://www.insurance.ca.gov/01-consumers/110-health/60-resources/NoSupriseBills.cfm\" target=\"_blank\" rel=\"noreferrer noopener\">consumer\u003c/a>\u003ca href=\"https://www.insurance.ca.gov/01-consumers/110-health/60-resources/NoSupriseBills.cfm\"> protections against surprise medical billing\u003c/a> for patients with private insurance.\u003c/p>\n\u003cp>“It’s the last remaining gap, but it’s a really big one,” she said. “You could be insured, but it doesn’t matter.”\u003c/p>\n\u003cfigure id=\"attachment_11971057\" class=\"wp-caption alignnone\" style=\"max-width: 2000px\">\u003ca href=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/121923-Surprise-Ambulance-LV_01-CM.jpeg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11971057\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/121923-Surprise-Ambulance-LV_01-CM.jpeg\" alt=\"A woman with glasses, sitting on an easy chair, holds a little boy on her lap.\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/121923-Surprise-Ambulance-LV_01-CM.jpeg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/121923-Surprise-Ambulance-LV_01-CM-800x533.jpeg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/121923-Surprise-Ambulance-LV_01-CM-1020x680.jpeg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/121923-Surprise-Ambulance-LV_01-CM-160x107.jpeg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/121923-Surprise-Ambulance-LV_01-CM-1536x1024.jpeg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/121923-Surprise-Ambulance-LV_01-CM-1920x1280.jpeg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Lainey Arebalo and her son Brady sitting in the living room of her parents’ home in Templeton, California, on Dec. 19, 2023. Minutes after Arebalo gave birth to Brady, doctors had him transported by ambulance to a neonatal intensive care unit, leaving the family with a hefty ambulance bill. \u003ccite>(Larry Valenzuela/CalMatters, CatchLight Local)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Approximately 14 million Californians with state-regulated private health plans will benefit from the law’s protections. According to an analysis by the Kaiser Family Foundation, \u003ca href=\"https://www.healthsystemtracker.org/brief/ground-ambulance-rides-and-potential-for-surprise-billing/#Among%20privately%20insured%20non-elderly%20people%20with%20an%20emergency%20room%20(ER)%20visit,%20the%20share%20who%20arrived%20to%20the%20ER%20by%20ambulance,%202018\">73% of all ground ambulance \u003c/a>\u003ca href=\"https://www.healthsystemtracker.org/brief/ground-ambulance-rides-and-potential-for-surprise-billing/#Among%20privately%20insured%20non-elderly%20people%20with%20an%20emergency%20room%20(ER)%20visit,%20the%20share%20who%20arrived%20to%20the%20ER%20by%20ambulance,%202018\" target=\"_blank\" rel=\"noreferrer noopener\">transports\u003c/a> in California resulted in an out-of-network charge in 2018 among people with large employer insurance. California also has the nation’s \u003ca href=\"https://publicinterestnetwork.org/wp-content/uploads/2022/12/EMERGENCY-The-high-cost-of-ambulance-surprise-bills-USPIRG-Education-Fund-December-2022-Final.pdf#=page9\" target=\"_blank\" rel=\"noreferrer noopener\">highest median surprise ambulance bill\u003c/a>, at $1,209, according to a study published last year by the U.S. Public Interest Research Group.\u003c/p>\n\u003cp>In a statement at the time of the law’s passage, Assemblymember \u003ca href=\"https://calmatters.org/legislator-tracker/tasha-boerner-horvath-1973/\">Tasha Boerner\u003c/a>, the Democrat from Carlsbad who authored the measure, said people have no control over which ambulance company picks them up in a time of crisis.\u003c/p>\n\u003cp>“The last thing anyone should be thinking about when they call 911 is whether they can afford the ambulance ride,” Boerner said in her statement.\u003c/p>\n\u003cp>[aside label=\"more health coverage\" tag=\"health-care\"]The law also protects uninsured people from receiving an expensive ambulance bill by limiting their out-of-pocket cost to the Medi-Cal or Medicare rate, whichever is greater. Medi-Cal is the state’s health insurance program for very low-income residents and already protects its enrollees from these types of bills.\u003c/p>\n\u003cp>About 6 million Californians enrolled in federally regulated health plans, many of whom work for multi-state or multinational companies, won’t be shielded by the law. Californians can ask their employer what kind of health plan they offer.\u003c/p>\n\u003ch2>$4,400 bill for newborn’s ambulance trip\u003c/h2>\n\u003cp>Lainey Arebalo is thankful that future emergencies will be covered in California. Her health insurance company doesn’t contract with any ambulance companies in San Luis Obispo County, where she and her family live, leaving them with no choice but to pay out of pocket.\u003c/p>\n\u003cp>In September, minutes after Arebalo gave birth to her son Brady, doctors decided to transfer him to a larger hospital about 20 miles away. Brady wasn’t breathing properly and needed to be admitted to a neonatal intensive care unit. The ambulance came and whisked him away.\u003c/p>\n\u003cp>Over the next month, letters started arriving from the ambulance company: Arebalo owed $4,400 for the transfer, she said.\u003c/p>\n\u003cp>“Here I am, you know, less than two months after giving birth, being told I would be sent to collections,” she said.\u003c/p>\n\u003cp>Insurance covered nearly all of Brady’s five-day hospital stay, which totaled $109,000, Arebalo said, but wouldn’t pay for the out-of-network ambulance ride. Eventually, insurance paid about a third of the bill after Arebalo filed a grievance, but the remaining unexpected expense still cut into the family’s finances.\u003c/p>\n\u003cp>She ended her maternity leave early to return to work as a special education teacher to help pay the bills and is now on a payment plan of $200 per month.\u003c/p>\n\u003cp>“It was definitely a surprise bill and one that I’m still paying,” Arebalo said.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>Supported by the California Health Care Foundation (CHCF), which works to ensure that\u003c/em> \u003cem>people have access to the care they need, when they need it, at a price they can afford. Visit \u003c/em>\u003ca href=\"http://www.chcf.org/\">\u003cem>www.chcf.org\u003c/em>\u003c/a>\u003cem> to learn more.\u003c/em>\u003c/p>\n\n",
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"excerpt": "Surprise ambulance bills can leave families deeply in debt after a medical emergency. A new state law forcing insurance companies to negotiate payments is expected to save Californians tens of millions of dollars a year.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cem>Lea este artículo en \u003ca href=\"https://calmatters.org/calmatters-en-espanol/2023/12/las-carisimas-facturas-por-uso-de-ambulancias-endeudaron-a-estas-familias-pero-una-nueva-ley-de-california-prohibe-la-practica/\">español\u003c/a>.\u003c/em>\u003c/p>\n\u003cp>The COVID-19 pandemic took a brutal toll on Danielle Miele’s family. But after two exorbitant ambulance bills, she’s now scared to call 911.\u003c/p>\n\u003cp>Her teenage son attempted suicide in 2022, Miele said. His mental health deteriorated during the pandemic, and he needed an ambulance transfer from the Roseville emergency room, where Miele took him to a treatment center in San Mateo. The ambulance company hit Miele with a $9,000 out-of-network charge, which was sent to collections “almost immediately,” she said.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>The virus also left Miele with seizures that mimic the symptoms of a heart attack, she said. Miele called 911 the first time a seizure happened. The 15-minute ride to the hospital cost $4,000 without help from insurance, she said.\u003c/p>\n\u003cp>“The last time I had one of my seizures, I basically said, ‘I’m going to die here at home. … I’m not getting another ambulance,’” Miele said. “I’d maybe rather die at home than have more medical debt.”\u003c/p>\n\u003cp>A \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=202320240AB716\" target=\"_blank\" rel=\"noreferrer noopener\">new California law\u003c/a> that takes effect Jan. 1 targets the kind of “surprise” ambulance bills that put Miele’s family in debt, even though they had medical insurance. These bills take the form of out-of-network charges for privately insured patients without control over which ambulance company responds to a call for help.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Under the new law, patients will only have to pay the equivalent of what they would have paid for an in-network service. Health insurance and ambulance companies will have to settle the bill directly even if they don’t have an existing contract.\u003c/p>\n\u003cp>Supporters of the new law argue it will make a big difference for thousands of families like Miele’s. The second time that Miele’s son needed an emergency psychiatric hold, the ambulance company that arrived was part of the family’s insurance network. Their co-pay: $83.\u003c/p>\n\u003cp>Ambulance companies did not oppose the legislation, which includes guarantees that health insurance plans reimburse them for services.\u003c/p>\n\u003ch2>Millions in surprise bills\u003c/h2>\n\u003cp>The California Association of Health Plans, which represents insurers, opposed the bill before it became law because of its potential to increase premiums by $67.3 million statewide. In contrast, people with private health insurance stand to save approximately $44.5 million in \u003ca href=\"https://www.chbrp.org/sites/default/files/bill-documents/AB716/AB%20716%20Final.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">direct\u003c/a>\u003ca href=\"https://www.chbrp.org/sites/default/files/bill-documents/AB716/AB%20716%20Final.pdf\"> charges for ambulance rides\u003c/a>, according to a legislative analysis.\u003c/p>\n\u003cp>Katie Van Deynze, a legislative advocate for Health Access California, a consumer advocacy group that sponsored the legislation, said the law closes a longstanding gap in California’s \u003ca href=\"https://www.insurance.ca.gov/01-consumers/110-health/60-resources/NoSupriseBills.cfm\" target=\"_blank\" rel=\"noreferrer noopener\">consumer\u003c/a>\u003ca href=\"https://www.insurance.ca.gov/01-consumers/110-health/60-resources/NoSupriseBills.cfm\"> protections against surprise medical billing\u003c/a> for patients with private insurance.\u003c/p>\n\u003cp>“It’s the last remaining gap, but it’s a really big one,” she said. “You could be insured, but it doesn’t matter.”\u003c/p>\n\u003cfigure id=\"attachment_11971057\" class=\"wp-caption alignnone\" style=\"max-width: 2000px\">\u003ca href=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/121923-Surprise-Ambulance-LV_01-CM.jpeg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11971057\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/121923-Surprise-Ambulance-LV_01-CM.jpeg\" alt=\"A woman with glasses, sitting on an easy chair, holds a little boy on her lap.\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/121923-Surprise-Ambulance-LV_01-CM.jpeg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/121923-Surprise-Ambulance-LV_01-CM-800x533.jpeg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/121923-Surprise-Ambulance-LV_01-CM-1020x680.jpeg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/121923-Surprise-Ambulance-LV_01-CM-160x107.jpeg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/121923-Surprise-Ambulance-LV_01-CM-1536x1024.jpeg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/121923-Surprise-Ambulance-LV_01-CM-1920x1280.jpeg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Lainey Arebalo and her son Brady sitting in the living room of her parents’ home in Templeton, California, on Dec. 19, 2023. Minutes after Arebalo gave birth to Brady, doctors had him transported by ambulance to a neonatal intensive care unit, leaving the family with a hefty ambulance bill. \u003ccite>(Larry Valenzuela/CalMatters, CatchLight Local)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Approximately 14 million Californians with state-regulated private health plans will benefit from the law’s protections. According to an analysis by the Kaiser Family Foundation, \u003ca href=\"https://www.healthsystemtracker.org/brief/ground-ambulance-rides-and-potential-for-surprise-billing/#Among%20privately%20insured%20non-elderly%20people%20with%20an%20emergency%20room%20(ER)%20visit,%20the%20share%20who%20arrived%20to%20the%20ER%20by%20ambulance,%202018\">73% of all ground ambulance \u003c/a>\u003ca href=\"https://www.healthsystemtracker.org/brief/ground-ambulance-rides-and-potential-for-surprise-billing/#Among%20privately%20insured%20non-elderly%20people%20with%20an%20emergency%20room%20(ER)%20visit,%20the%20share%20who%20arrived%20to%20the%20ER%20by%20ambulance,%202018\" target=\"_blank\" rel=\"noreferrer noopener\">transports\u003c/a> in California resulted in an out-of-network charge in 2018 among people with large employer insurance. California also has the nation’s \u003ca href=\"https://publicinterestnetwork.org/wp-content/uploads/2022/12/EMERGENCY-The-high-cost-of-ambulance-surprise-bills-USPIRG-Education-Fund-December-2022-Final.pdf#=page9\" target=\"_blank\" rel=\"noreferrer noopener\">highest median surprise ambulance bill\u003c/a>, at $1,209, according to a study published last year by the U.S. Public Interest Research Group.\u003c/p>\n\u003cp>In a statement at the time of the law’s passage, Assemblymember \u003ca href=\"https://calmatters.org/legislator-tracker/tasha-boerner-horvath-1973/\">Tasha Boerner\u003c/a>, the Democrat from Carlsbad who authored the measure, said people have no control over which ambulance company picks them up in a time of crisis.\u003c/p>\n\u003cp>“The last thing anyone should be thinking about when they call 911 is whether they can afford the ambulance ride,” Boerner said in her statement.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>The law also protects uninsured people from receiving an expensive ambulance bill by limiting their out-of-pocket cost to the Medi-Cal or Medicare rate, whichever is greater. Medi-Cal is the state’s health insurance program for very low-income residents and already protects its enrollees from these types of bills.\u003c/p>\n\u003cp>About 6 million Californians enrolled in federally regulated health plans, many of whom work for multi-state or multinational companies, won’t be shielded by the law. Californians can ask their employer what kind of health plan they offer.\u003c/p>\n\u003ch2>$4,400 bill for newborn’s ambulance trip\u003c/h2>\n\u003cp>Lainey Arebalo is thankful that future emergencies will be covered in California. Her health insurance company doesn’t contract with any ambulance companies in San Luis Obispo County, where she and her family live, leaving them with no choice but to pay out of pocket.\u003c/p>\n\u003cp>In September, minutes after Arebalo gave birth to her son Brady, doctors decided to transfer him to a larger hospital about 20 miles away. Brady wasn’t breathing properly and needed to be admitted to a neonatal intensive care unit. The ambulance came and whisked him away.\u003c/p>\n\u003cp>Over the next month, letters started arriving from the ambulance company: Arebalo owed $4,400 for the transfer, she said.\u003c/p>\n\u003cp>“Here I am, you know, less than two months after giving birth, being told I would be sent to collections,” she said.\u003c/p>\n\u003cp>Insurance covered nearly all of Brady’s five-day hospital stay, which totaled $109,000, Arebalo said, but wouldn’t pay for the out-of-network ambulance ride. Eventually, insurance paid about a third of the bill after Arebalo filed a grievance, but the remaining unexpected expense still cut into the family’s finances.\u003c/p>\n\u003cp>She ended her maternity leave early to return to work as a special education teacher to help pay the bills and is now on a payment plan of $200 per month.\u003c/p>\n\u003cp>“It was definitely a surprise bill and one that I’m still paying,” Arebalo said.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>Supported by the California Health Care Foundation (CHCF), which works to ensure that\u003c/em> \u003cem>people have access to the care they need, when they need it, at a price they can afford. Visit \u003c/em>\u003ca href=\"http://www.chcf.org/\">\u003cem>www.chcf.org\u003c/em>\u003c/a>\u003cem> to learn more.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>\u003cem>Updated 1:30 p.m. Wednesday\u003c/em>\u003c/p>\n\u003cp>Winter in California has begun with foggy mornings, rainy nights and planning holiday dinners with family and friends. And like the past few winters, we’re also seeing COVID-19 infections creep back up across the state despite less free and easily accessible testing sites.\u003c/p>\n\u003cp>In early November, 6.2% of the PCR tests for COVID-19 administered in California came back positive, \u003ca href=\"https://www.cdph.ca.gov/Programs/CID/DCDC/Pages/Respiratory-Viruses/RespiratoryDashboard.aspx\">according to the state’s most recent data showing the seven-day average of those positivity rates.\u003c/a> One month later, the state’s most recent data from Dec. 4 shows that this rate has climbed to 8.8%.\u003c/p>\n\u003cp>The rate of positive COVID-19 tests has increased every winter since the start of the pandemic. In January 2022, the infection rate surpassed 20%, partly due to the spread of the powerful omicron variant. During that time, one out of every five tests administered in the state came back positive.\u003c/p>\n\u003cp>Even if you’re up to date with your vaccines and have \u003ca href=\"https://www.kqed.org/news/11960630/free-new-covid-vaccine-near-me-2023\">received the new updated COVID-19 vaccine\u003c/a>, it’s perfectly normal to feel still anxious about the coronavirus, especially if you plan to spend time with family and friends during the holiday season. On Nov. 30, public health officials from all nine Bay Area counties \u003ca href=\"https://sf.gov/news/respiratory-viruses-circulating-all-bay-area-health-officers-recommend-actions-stay-healthy\">published a list of recommendations to prevent respiratory infections\u003c/a> (COVID-19, RSV and the flu) during the holidays. Among these recommendations is stocking up on at-home COVID-19 tests.[aside postID=\"news_11940562\" hero=\"https://ww2.kqed.org/app/uploads/sites/10/2023/02/RS62644_GettyImages-1237599780-qut-1020x680.jpg\"]The federal government is still \u003ca href=\"https://www.kqed.org/news/11940562/how-to-find-a-free-covid-test-near-you-in-2023-because-its-getting-harder\">giving out four free COVID-19 tests to every household\u003c/a>. And yes, for many families four tests may just not be enough, especially considering that the high season for COVID-19 infections lasts several months. However, many insurance companies in California will still reimburse you for at-home tests you buy at the store or pharmacy.\u003c/p>\n\u003cp>The process of reimbursing for at-home COVID-19 tests \u003ca href=\"https://www.latimes.com/california/story/2023-02-07/with-covid-emergency-ending-will-i-have-to-pay-for-tests\">has changed in the last month\u003c/a>, and each insurer is reimbursing members differently. KQED reached out to every major health insurance company in California to learn what they’re doing and what members need to know.\u003c/p>\n\u003ch2>What rules have changed for health insurance companies?\u003c/h2>\n\u003cp>At the start of 2022, the federal government required insurers to reimburse their members for up to eight monthly at-home COVID-19 tests, regardless of where those tests were purchased. That federal rule lasted for over a year and ended in May 2023, when the federal state of emergency ended — but in California, state law extended it for six more months until Nov. 11.\u003c/p>\n\u003cp>Nov. 11 has come and gone, and there are some new rules to keep an eye out for.\u003c/p>\n\u003cp>\u003ca href=\"https://www.kqed.org/news/11941075/californias-covid-emergency-ends-feb-28-what-does-that-actually-mean-for-you\">Insurers are \u003cem>still\u003c/em> required to reimburse members for up to eight at-home tests\u003c/a> as long as these tests are now obtained “in-network” with your insurer. However, other insurers will continue to reimburse you for tests regardless of where you buy them.\u003c/p>\n\u003cp>Of course, each insurance company does this a little differently — so make sure you know what’s available for you according to your plan before buying a test. And if you’re in any doubt, contact your insurer directly to find out what you’re eligible for \u003cem>before\u003c/em> you purchase any tests.\u003c/p>\n\u003ch2>How does my insurance company handle reimbursements for at-home COVID-19 tests?\u003c/h2>\n\u003cp>\u003cb>Kaiser Permanente\u003c/b>\u003c/p>\n\u003cp>Before Nov. 11, Kaiser Permanente members could buy at-home tests from any pharmacy or store and get reimbursed by completing a form. That process is no longer in place. Kaiser Permanente told KQED: “ If members get a COVID-19 vaccine, testing, or drug therapy outside of Kaiser Permanente after Nov. 11, they’ll be responsible for cost-sharing.”\u003c/p>\n\u003cp>Members, however, can receive up to eight home tests per month at no cost when they go to a Kaiser Permanente pharmacy. You can also order your eight tests online through the member services website, \u003ca href=\"https://healthy.kaiserpermanente.org/northern-california/front-door\">kp.org\u003c/a>.\u003c/p>\n\u003cp>One thing to keep in mind: If you order your tests through kp. org, you are not guaranteed a reimbursement. Kaiser Permanente told KQED that tests ordered through kp.org are “low cost” and members “may be eligible for reimbursement, depending on their plan.” For this reason, it may be worth contacting Kaiser’s membership services (as listed on your insurance card) to double-check your tests \u003cem>will\u003c/em> be free when ordered online.\u003c/p>\n\u003cp>The eight monthly tests are available to each Kaiser member, regardless of age. So if you, your spouse and two children are all covered by Kaiser Permanente, you can order up to 32 home tests each month through kp.org.\u003c/p>\n\u003cp>\u003cb>Blue Shield of California\u003c/b>\u003c/p>\n\u003cp>Blue Shield continues to fully reimburse policyholders for the cost of up to eight at-home tests each month. “Nothing regarding in-home COVID-19 testing has changed since Nov. 12,” the insurer told KQED.\u003c/p>\n\u003cp>Members can also buy home tests from anywhere. Unlike other insurance companies, Blue Shield does not have a network of preferred home test brands or providers. Once a member purchases their tests, \u003ca href=\"https://www.blueshieldca.com/bsca/bsc/public/common/PortalComponents/sites/StreamDocumentServlet?fileName=SITES_Other_2022_COVID%20Test%20Claim%20Form_v1_12232021.pdf\">they must complete a reimbursement claim form\u003c/a> and mail it to Blue Shield.[aside label='More Guides from KQED' tag='audience-news']Keep in mind that Blue Shield will only cover the cost of up to eight tests per month, max. You will not be reimbursed for the ninth test if you buy nine tests in one month. And if you are looking to get an in-person COVID-19 test done, for that, you \u003ci>will\u003c/i> have to go to an in-network provider so the cost of the test is covered.\u003c/p>\n\u003cp>\u003cb>Anthem Blue Cross\u003c/b>\u003c/p>\n\u003cp>Anthem Blue Cross has confirmed with KQED that it will continue to reimburse members with certain plans for at-home tests. You can buy the tests from any seller and are not limited to a specific network of test providers.\u003c/p>\n\u003cp>Keep in mind that there are some plans that do not qualify for reimbursements and based on the information that Anthem Blue Cross provided KQED, it seems that a member will only know if they qualify once they have filed a reimbursement claim.\u003c/p>\n\u003cp>To file a claim, first, make sure you still have the receipts from when you bought the tests because you will need to submit them later on. If you got the tests online, say through Amazon, you can find an electronic receipt when you go to your purchasing history. Once you have your receipts secured, \u003ca href=\"https://www.anthem.com/ca/login/?dplid=sso.dpl.rcp.member%2Fclaim-form\">head over to the Anthem Blue Cross member website\u003c/a>. If you use the SydneySM Health app, you can use that too.\u003c/p>\n\u003cp>Once you’ve logged in, click on “Claims” and select “Submit a Claim,” and that’s where you will complete an electronic form with all the details from your purchase.\u003c/p>\n\u003cp>And remember that in California, this insurer goes by \u003cstrong>Anthem Blue Cross\u003c/strong>, and in other states, it is called \u003cstrong>Anthem Blue Cross and Blue Shield\u003c/strong>. Distinguishing between the two is especially important to make sure you get the right benefits that correspond to your insurance plan. For example, \u003cstrong>Anthem Blue Cross and Blue Shield\u003c/strong> are no longer reimbursing members for at-home COVID-19 tests in other states, but \u003cstrong>Anthem Blue Cross\u003c/strong>, as explained above, is still covering members in California for these tests.\u003c/p>\n\u003cp>\u003cb>Aetna\u003c/b>\u003c/p>\n\u003cp>Aetna continues to cover the costs of up to eight at-home COVID-19 tests per month. This includes members with Aetna coverage through their employer and those on Medi-Cal.\u003c/p>\n\u003cp>To get reimbursed, policyholders should \u003ca href=\"https://member.aetna.com/MbrLanding/RoutingServlet?createSession=true&custNumSel=A&serviceName=home&ae_ptparam_cmpId=int_aetnaco\">log into Aetna’s member website\u003c/a> using their insurance plan credentials. Once logged in, click on “Submit a claim for reimbursement.” You’ll then see an electronic form that asks you for certain information, including the location and date of your purchase and a photo or scan of the receipt to verify your purchase.\u003c/p>\n\u003cp>If you are on a commercial plan and have Pharmacy Benefit coverage, there is a list of pharmacies that Aetna considers “in-network.” To make sure you get a reimbursement for the tests you buy, it’s probably best to buy them at an in-network pharmacy. If you receive Aetna coverage through Medi-Cal, you can buy tests from anywhere, regardless if the seller is in-network or not.\u003c/p>\n\u003cp>One last thing to keep in mind: Aetna members can currently request reimbursement through an online form. But that option will be discontinued at the end of this year. In 2024, the insurer says that you will need to call Member Services directly to request a reimbursement over the phone.\u003c/p>\n\u003cp>\u003cb>UnitedHealthcare and Cigna\u003c/b>\u003c/p>\n\u003cp>KQED has repeatedly reached out to UnitedHealthcare and Cigna but has not received an answer from either insurer’s media team. We’ll be updating this story once we have new information.\u003c/p>\n\u003ch2>What if I don’t have health insurance?\u003c/h2>\n\u003cp>Remember, you don’t need health insurance to order four free at-home COVID-19 tests online from the federal government. \u003ca href=\"https://www.kqed.org/news/11940562/how-to-find-a-free-covid-test-near-you-in-2023-because-its-getting-harder\">Read more about how to order four free tests per residential address via USPS.\u003c/a>\u003c/p>\n\u003cp>If you or someone in your community doesn’t have access to the internet to order these free tests, USPS says you can contact their helpline by calling 1-800-232-0233 (TTY 1-888-720-7489). You should also be prepared for potentially long wait times using this helpline.\u003c/p>\n\u003cp>Other ways of finding a free or low-cost COVID-19 test may still be available, using the CDC’s No-Cost Testing Locator or through your Bay Area county. These tests may be antigen tests or PCR tests. \u003ca href=\"https://www.kqed.org/news/11940562/how-to-find-a-free-covid-test-near-you-in-2023-because-its-getting-harder#findtests\">Read more about where to find a free or low-cost test near you.\u003c/a>\u003c/p>\n\u003cp>\u003cem>KQED’s Carly Severn contributed to this story.\u003c/em>\u003c/p>\n\u003ch2>\u003ca id=\"tellus\">\u003c/a>Tell us: What else do you need information about?\u003c/h2>\n\u003cp>At KQED News, we know that it can sometimes be hard to track down the answers to navigate life in the Bay Area in 2023. We’ve published \u003ca href=\"https://www.kqed.org/news/tag/coronavirus-resources-and-explainers\">clear, helpful explainers and guides about issues like COVID-19\u003c/a>, \u003ca href=\"https://www.kqed.org/news/11936674/how-to-prepare-for-this-weeks-atmospheric-river-storm-sandbags-emergency-kits-and-more\">how to cope with intense winter weather\u003c/a>, and \u003ca href=\"https://www.kqed.org/news/11821950/how-to-safely-attend-a-protest-in-the-bay-area\">how to exercise your right to protest safely\u003c/a>.\u003c/p>\n\u003cp>So tell us: What do you need to know more about? Tell us, and you could see your question answered online or on social media. What you submit will make our reporting stronger and help us decide what to cover here on our site and on KQED Public Radio, too.\u003c/p>\n\u003cp>[hearken id=\"10483\" src=\"https://modules.wearehearken.com/kqed/embed/10483.js\"]\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cem>Updated 1:30 p.m. Wednesday\u003c/em>\u003c/p>\n\u003cp>Winter in California has begun with foggy mornings, rainy nights and planning holiday dinners with family and friends. And like the past few winters, we’re also seeing COVID-19 infections creep back up across the state despite less free and easily accessible testing sites.\u003c/p>\n\u003cp>In early November, 6.2% of the PCR tests for COVID-19 administered in California came back positive, \u003ca href=\"https://www.cdph.ca.gov/Programs/CID/DCDC/Pages/Respiratory-Viruses/RespiratoryDashboard.aspx\">according to the state’s most recent data showing the seven-day average of those positivity rates.\u003c/a> One month later, the state’s most recent data from Dec. 4 shows that this rate has climbed to 8.8%.\u003c/p>\n\u003cp>The rate of positive COVID-19 tests has increased every winter since the start of the pandemic. In January 2022, the infection rate surpassed 20%, partly due to the spread of the powerful omicron variant. During that time, one out of every five tests administered in the state came back positive.\u003c/p>\n\u003cp>Even if you’re up to date with your vaccines and have \u003ca href=\"https://www.kqed.org/news/11960630/free-new-covid-vaccine-near-me-2023\">received the new updated COVID-19 vaccine\u003c/a>, it’s perfectly normal to feel still anxious about the coronavirus, especially if you plan to spend time with family and friends during the holiday season. On Nov. 30, public health officials from all nine Bay Area counties \u003ca href=\"https://sf.gov/news/respiratory-viruses-circulating-all-bay-area-health-officers-recommend-actions-stay-healthy\">published a list of recommendations to prevent respiratory infections\u003c/a> (COVID-19, RSV and the flu) during the holidays. Among these recommendations is stocking up on at-home COVID-19 tests.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>The federal government is still \u003ca href=\"https://www.kqed.org/news/11940562/how-to-find-a-free-covid-test-near-you-in-2023-because-its-getting-harder\">giving out four free COVID-19 tests to every household\u003c/a>. And yes, for many families four tests may just not be enough, especially considering that the high season for COVID-19 infections lasts several months. However, many insurance companies in California will still reimburse you for at-home tests you buy at the store or pharmacy.\u003c/p>\n\u003cp>The process of reimbursing for at-home COVID-19 tests \u003ca href=\"https://www.latimes.com/california/story/2023-02-07/with-covid-emergency-ending-will-i-have-to-pay-for-tests\">has changed in the last month\u003c/a>, and each insurer is reimbursing members differently. KQED reached out to every major health insurance company in California to learn what they’re doing and what members need to know.\u003c/p>\n\u003ch2>What rules have changed for health insurance companies?\u003c/h2>\n\u003cp>At the start of 2022, the federal government required insurers to reimburse their members for up to eight monthly at-home COVID-19 tests, regardless of where those tests were purchased. That federal rule lasted for over a year and ended in May 2023, when the federal state of emergency ended — but in California, state law extended it for six more months until Nov. 11.\u003c/p>\n\u003cp>Nov. 11 has come and gone, and there are some new rules to keep an eye out for.\u003c/p>\n\u003cp>\u003ca href=\"https://www.kqed.org/news/11941075/californias-covid-emergency-ends-feb-28-what-does-that-actually-mean-for-you\">Insurers are \u003cem>still\u003c/em> required to reimburse members for up to eight at-home tests\u003c/a> as long as these tests are now obtained “in-network” with your insurer. However, other insurers will continue to reimburse you for tests regardless of where you buy them.\u003c/p>\n\u003cp>Of course, each insurance company does this a little differently — so make sure you know what’s available for you according to your plan before buying a test. And if you’re in any doubt, contact your insurer directly to find out what you’re eligible for \u003cem>before\u003c/em> you purchase any tests.\u003c/p>\n\u003ch2>How does my insurance company handle reimbursements for at-home COVID-19 tests?\u003c/h2>\n\u003cp>\u003cb>Kaiser Permanente\u003c/b>\u003c/p>\n\u003cp>Before Nov. 11, Kaiser Permanente members could buy at-home tests from any pharmacy or store and get reimbursed by completing a form. That process is no longer in place. Kaiser Permanente told KQED: “ If members get a COVID-19 vaccine, testing, or drug therapy outside of Kaiser Permanente after Nov. 11, they’ll be responsible for cost-sharing.”\u003c/p>\n\u003cp>Members, however, can receive up to eight home tests per month at no cost when they go to a Kaiser Permanente pharmacy. You can also order your eight tests online through the member services website, \u003ca href=\"https://healthy.kaiserpermanente.org/northern-california/front-door\">kp.org\u003c/a>.\u003c/p>\n\u003cp>One thing to keep in mind: If you order your tests through kp. org, you are not guaranteed a reimbursement. Kaiser Permanente told KQED that tests ordered through kp.org are “low cost” and members “may be eligible for reimbursement, depending on their plan.” For this reason, it may be worth contacting Kaiser’s membership services (as listed on your insurance card) to double-check your tests \u003cem>will\u003c/em> be free when ordered online.\u003c/p>\n\u003cp>The eight monthly tests are available to each Kaiser member, regardless of age. So if you, your spouse and two children are all covered by Kaiser Permanente, you can order up to 32 home tests each month through kp.org.\u003c/p>\n\u003cp>\u003cb>Blue Shield of California\u003c/b>\u003c/p>\n\u003cp>Blue Shield continues to fully reimburse policyholders for the cost of up to eight at-home tests each month. “Nothing regarding in-home COVID-19 testing has changed since Nov. 12,” the insurer told KQED.\u003c/p>\n\u003cp>Members can also buy home tests from anywhere. Unlike other insurance companies, Blue Shield does not have a network of preferred home test brands or providers. Once a member purchases their tests, \u003ca href=\"https://www.blueshieldca.com/bsca/bsc/public/common/PortalComponents/sites/StreamDocumentServlet?fileName=SITES_Other_2022_COVID%20Test%20Claim%20Form_v1_12232021.pdf\">they must complete a reimbursement claim form\u003c/a> and mail it to Blue Shield.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Keep in mind that Blue Shield will only cover the cost of up to eight tests per month, max. You will not be reimbursed for the ninth test if you buy nine tests in one month. And if you are looking to get an in-person COVID-19 test done, for that, you \u003ci>will\u003c/i> have to go to an in-network provider so the cost of the test is covered.\u003c/p>\n\u003cp>\u003cb>Anthem Blue Cross\u003c/b>\u003c/p>\n\u003cp>Anthem Blue Cross has confirmed with KQED that it will continue to reimburse members with certain plans for at-home tests. You can buy the tests from any seller and are not limited to a specific network of test providers.\u003c/p>\n\u003cp>Keep in mind that there are some plans that do not qualify for reimbursements and based on the information that Anthem Blue Cross provided KQED, it seems that a member will only know if they qualify once they have filed a reimbursement claim.\u003c/p>\n\u003cp>To file a claim, first, make sure you still have the receipts from when you bought the tests because you will need to submit them later on. If you got the tests online, say through Amazon, you can find an electronic receipt when you go to your purchasing history. Once you have your receipts secured, \u003ca href=\"https://www.anthem.com/ca/login/?dplid=sso.dpl.rcp.member%2Fclaim-form\">head over to the Anthem Blue Cross member website\u003c/a>. If you use the SydneySM Health app, you can use that too.\u003c/p>\n\u003cp>Once you’ve logged in, click on “Claims” and select “Submit a Claim,” and that’s where you will complete an electronic form with all the details from your purchase.\u003c/p>\n\u003cp>And remember that in California, this insurer goes by \u003cstrong>Anthem Blue Cross\u003c/strong>, and in other states, it is called \u003cstrong>Anthem Blue Cross and Blue Shield\u003c/strong>. Distinguishing between the two is especially important to make sure you get the right benefits that correspond to your insurance plan. For example, \u003cstrong>Anthem Blue Cross and Blue Shield\u003c/strong> are no longer reimbursing members for at-home COVID-19 tests in other states, but \u003cstrong>Anthem Blue Cross\u003c/strong>, as explained above, is still covering members in California for these tests.\u003c/p>\n\u003cp>\u003cb>Aetna\u003c/b>\u003c/p>\n\u003cp>Aetna continues to cover the costs of up to eight at-home COVID-19 tests per month. This includes members with Aetna coverage through their employer and those on Medi-Cal.\u003c/p>\n\u003cp>To get reimbursed, policyholders should \u003ca href=\"https://member.aetna.com/MbrLanding/RoutingServlet?createSession=true&custNumSel=A&serviceName=home&ae_ptparam_cmpId=int_aetnaco\">log into Aetna’s member website\u003c/a> using their insurance plan credentials. Once logged in, click on “Submit a claim for reimbursement.” You’ll then see an electronic form that asks you for certain information, including the location and date of your purchase and a photo or scan of the receipt to verify your purchase.\u003c/p>\n\u003cp>If you are on a commercial plan and have Pharmacy Benefit coverage, there is a list of pharmacies that Aetna considers “in-network.” To make sure you get a reimbursement for the tests you buy, it’s probably best to buy them at an in-network pharmacy. If you receive Aetna coverage through Medi-Cal, you can buy tests from anywhere, regardless if the seller is in-network or not.\u003c/p>\n\u003cp>One last thing to keep in mind: Aetna members can currently request reimbursement through an online form. But that option will be discontinued at the end of this year. In 2024, the insurer says that you will need to call Member Services directly to request a reimbursement over the phone.\u003c/p>\n\u003cp>\u003cb>UnitedHealthcare and Cigna\u003c/b>\u003c/p>\n\u003cp>KQED has repeatedly reached out to UnitedHealthcare and Cigna but has not received an answer from either insurer’s media team. We’ll be updating this story once we have new information.\u003c/p>\n\u003ch2>What if I don’t have health insurance?\u003c/h2>\n\u003cp>Remember, you don’t need health insurance to order four free at-home COVID-19 tests online from the federal government. \u003ca href=\"https://www.kqed.org/news/11940562/how-to-find-a-free-covid-test-near-you-in-2023-because-its-getting-harder\">Read more about how to order four free tests per residential address via USPS.\u003c/a>\u003c/p>\n\u003cp>If you or someone in your community doesn’t have access to the internet to order these free tests, USPS says you can contact their helpline by calling 1-800-232-0233 (TTY 1-888-720-7489). You should also be prepared for potentially long wait times using this helpline.\u003c/p>\n\u003cp>Other ways of finding a free or low-cost COVID-19 test may still be available, using the CDC’s No-Cost Testing Locator or through your Bay Area county. These tests may be antigen tests or PCR tests. \u003ca href=\"https://www.kqed.org/news/11940562/how-to-find-a-free-covid-test-near-you-in-2023-because-its-getting-harder#findtests\">Read more about where to find a free or low-cost test near you.\u003c/a>\u003c/p>\n\u003cp>\u003cem>KQED’s Carly Severn contributed to this story.\u003c/em>\u003c/p>\n\u003ch2>\u003ca id=\"tellus\">\u003c/a>Tell us: What else do you need information about?\u003c/h2>\n\u003cp>At KQED News, we know that it can sometimes be hard to track down the answers to navigate life in the Bay Area in 2023. We’ve published \u003ca href=\"https://www.kqed.org/news/tag/coronavirus-resources-and-explainers\">clear, helpful explainers and guides about issues like COVID-19\u003c/a>, \u003ca href=\"https://www.kqed.org/news/11936674/how-to-prepare-for-this-weeks-atmospheric-river-storm-sandbags-emergency-kits-and-more\">how to cope with intense winter weather\u003c/a>, and \u003ca href=\"https://www.kqed.org/news/11821950/how-to-safely-attend-a-protest-in-the-bay-area\">how to exercise your right to protest safely\u003c/a>.\u003c/p>\n\u003cp>So tell us: What do you need to know more about? Tell us, and you could see your question answered online or on social media. What you submit will make our reporting stronger and help us decide what to cover here on our site and on KQED Public Radio, too.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"title": "What to Do if You’re Losing Your Medical Coverage in California",
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"content": "\u003cp>\u003cem>Lea este artículo en \u003ca href=\"https://calmatters.org/calmatters-en-espanol/2023/09/miles-de-californianos-pierden-medi-cal-cada-mes-que-puede-hacer-si-pierde-la-cobertura/\">español\u003c/a>.\u003c/em>\u003c/p>\n\u003cp>Tens of thousands of Californians are losing health insurance every month as the state resumes checking people’s eligibility for Medi-Cal, which it suspended during the COVID-19 public health emergency.\u003c/p>\n\u003cp>About 16 million people in California will be evaluated for eligibility from June 2023 to May 2024. About half of those up for a review were automatically renewed because officials were able to verify their information in the system. Others were sent yellow renewal packets that they were supposed to fill out and send back to their county Medi-Cal office.\u003c/p>\n\u003cp>More than 300,000 Californians have lost their Medi-Cal eligibility since July 1. The majority of lost coverage in June and July was due to procedural reasons, such as not sending their renewal forms back or having \u003ca href=\"https://www.dhcs.ca.gov/dataandstats/Pages/Continuous-Coverage-Eligibility-Unwinding-Dashboard.aspx\">incorrect information in their forms\u003c/a>, according to state data.\u003c/p>\n\u003cp>Some people losing coverage are no longer eligible because of changes in their personal lives, such as starting a job with higher pay. But some might see their coverage lapse because of paperwork mistakes or simply missing a notice in the mail.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“It’s because it’s been such a long period where folks have not had to renew their health coverage,” said Cary Sanders, senior policy director at the California Pan-Ethnic Health Network. “There could be up to 2 to 3 million Californians who could lose their health coverage just by virtue of this change, because there would be people who wouldn’t know what to do.”\u003c/p>\n\u003cp>Here are some answers to questions about what you can do if you lose coverage, including how to appeal.\u003c/p>\n\u003ch2>How do I know if I got disenrolled from Medi-Cal?\u003c/h2>\n\u003cp>You will get notified through mail. If you didn’t receive a notification but still believe you might have lost coverage, you can call your local Medi-Cal office to check eligibility or go to your regular clinic or hospital where they can look this information up for you.\u003c/p>\n\u003cp>For any questions about Medi-Cal eligibility, you can contact the state \u003ca href=\"https://www.dhcs.ca.gov/\">Department of Health Care Services\u003c/a>, which manages the Medi-Cal program. Its \u003ca href=\"https://www.dhcs.ca.gov/services/medi-cal/eligibility/Pages/Medi-Cal%20Eligibility%20Division.aspx\">Medi-Cal Eligibility Division\u003c/a> can be contacted at (916) 552-9200.\u003c/p>\n\u003ch2>I qualify for Medi-Cal but still got disenrolled. What should I do?\u003c/h2>\n\u003cp>Your next step depends on how much time has lapsed since you lost your coverage, as stated on the official notification letter.\u003c/p>\n\u003cp>[aside postID=news_11944543 hero='https://ww2.kqed.org/app/uploads/sites/10/2023/03/pexels-thirdman-5327584.jpg']The state has instituted a 90-day appeal period in case you lost coverage even though you qualify.\u003c/p>\n\u003cp>If you are within the 90-day period, you should immediately fill out the yellow renewal packet, or supply any missing information, and send it to your county Medi-Cal office. If you lost the packet or sent the packet but still got disenrolled, call your local Medi-Cal office or go to your regular clinic or hospital to figure out the next steps.\u003c/p>\n\u003cp>If you are unable to send your information to your local Medi-Cal office due to accessibility issues and are running out of time, ask the office staff to accept your documents electronically or through the phone.\u003c/p>\n\u003cp>If you are past the 90-day period, you will be required to reapply for Medi-Cal benefits. This means starting a new application entirely.\u003c/p>\n\u003ch2>How can I appeal?\u003c/h2>\n\u003cp>Tatiana Fassieux, training and education specialist at Medicare advocacy nonprofit California Health Advocates, said people should remember that they have rights to appeal.\u003c/p>\n\u003cp>If you received a notification about disenrollment, you can request \u003ca href=\"https://www.dhcs.ca.gov/services/medi-cal/Pages/Medi-CalFairHearing.aspx\">a Fair Hearing\u003c/a> and appeal the loss of coverage. This will ensure that your benefits continue until the hearing is resolved.\u003c/p>\n\u003cp>“Many people take the letter verbatim and they don’t read it and they don’t appeal,” she said.\u003c/p>\n\u003cp>According to the state Department of Health Care Services, adults under the age of 26 or over age 50 can qualify for Medi-Cal regardless of immigration status. Medi-Cal does not share information with the immigration office, so undocumented Californians should not be afraid to seek help. Starting Jan. 1. Californians of all ages will be able to qualify for Medi-Cal irrespective of immigration status.\u003c/p>\n\u003ch2>I got disenrolled because I no longer qualify. How can I get health insurance?\u003c/h2>\n\u003cp>If you no longer qualify for Medi-Cal, you may still be able to get low-cost health insurance through \u003ca href=\"https://www.coveredca.com/\">Covered California,\u003c/a> which is the state’s marketplace for health insurance plans.\u003c/p>\n\u003cp>[aside postID=news_11942493]Those who earn up to 250% of the federal poverty level — or $33,975 for an individual or $69,375 for a family of four — would qualify for low-premium plans through Covered California. You may also be eligible for additional health insurance subsidies through \u003ca href=\"https://www.healthforcalifornia.com/covered-california?gclid=CjwKCAjwu4WoBhBkEiwAojNdXjuBHyXGv9QJ2WvwCQzjCMswHa1vsR1UuxKuTWc4ZI-l4ObZEcUNSxoCbQsQAvD_BwE\">the Affordable Care Act (ACA)\u003c/a>, including \u003ca href=\"https://www.irs.gov/affordable-care-act/individuals-and-families/the-premium-tax-credit-the-basics\">the Advance Premium Tax Credit\u003c/a> and \u003ca href=\"https://www.healthforcalifornia.com/covered-california/cost-sharing?gclid=CjwKCAjwu4WoBhBkEiwAojNdXm8haH2iO9JNelTbsVelQiCRS6uKUAGaOnFPfnOXFmDtuJX4TuxvahoCL8IQAvD_BwE\">Cost-Sharing Reduction plans\u003c/a>.\u003c/p>\n\u003cp>If you are over the age of 65 or have disabilities, you may also qualify for \u003ca href=\"https://www.medicare.gov/what-medicare-covers/your-medicare-coverage-choices/whats-medicare\">Medicare\u003c/a> (in addition), which can help pay for hospital costs, medical care and even prescription medication.\u003c/p>\n\u003ch2>How can I make sure I don’t get disenrolled in the future?\u003c/h2>\n\u003cp>Keep an eye out for any mail sent to you from your county Medi-Cal office. If you recently moved, make sure to update your address on the Medi-Cal website or by calling your local office.\u003c/p>\n\u003cp>You will be expected to renew and update your Medi-Cal coverage every year, so keep all your important information in an accessible place.\u003c/p>\n\u003cp>“You should have your documents like tax returns and health records handy,” Fassieux said.\u003c/p>\n\u003cp>You can \u003ca href=\"https://www.dhcs.ca.gov/pages/keep-your-medi-cal.aspx?utm_source=keepmedicalcoverage.org&utm_medium=referral&utm_campaign=keep-mc-coverage\">sign up\u003c/a> for renewal reminders through the state’s renewal website: keepmedicalcoverage.org. That resource also is \u003ca href=\"https://www.dhcs.ca.gov/Pages/mantenga-su-medi-cal.aspx\">available from the state in Spanish\u003c/a>.\u003c/p>\n\u003ch2>Are there any other resources I can use for help?\u003c/h2>\n\u003cp>The state’s Department of Health Care Services has several resources to help, including \u003ca href=\"https://www.dhcs.ca.gov/services/medi-cal/Pages/CountyOffices.aspx\">contact information for your local Medi-Cal office\u003c/a>, schedules of \u003ca href=\"https://www.dhcs.ca.gov/services/medi-cal/eligibility/Pages/Partner-Community-Events.aspx\">community events and health fairs\u003c/a> where you can get information in person, and guides on \u003ca href=\"https://www.dhcs.ca.gov/pages/keep-your-medi-cal.aspx\">what to do if you lost Medi-Cal coverage\u003c/a>.\u003c/p>\n\u003cp>For assistance with Medi-Cal re-enrollment, you also can call the Office of the Medi-Cal Ombudsman. The office is a neutral resource that can help you deal with any issues you may have with the program. You can contact \u003ca href=\"https://www.dhcs.ca.gov/services/medi-cal/Pages/MMCDOfficeoftheOmbudsman.aspx\">the Office of the Ombudsman\u003c/a> at (888) 452-8609.\u003c/p>\n\u003cp>There are also several third-party services that can help you get back on Medi-Cal.\u003c/p>\n\u003cp>\u003ca href=\"https://healthconsumer.org/\">Health Consumer Alliance\u003c/a> is a free assistance program funded by The California Endowment, Covered California, the state Department of Managed Health Care and the Blue Shield Foundation. It provides legal services and can help you renew your Medi-Cal coverage. To get in touch, you can read \u003ca href=\"https://healthconsumer.org/covid19/\">their guide on renewing Medi-Cal\u003c/a> or call their toll-free number, 888‑804‑3536.\u003c/p>\n\u003cp>You can contact \u003ca href=\"https://benefitscal.com/\">BenefitsCal\u003c/a> which also provides assistance with Medi-Cal. The website has translations in 20 languages.\u003c/p>\n\u003ch2>Will seniors and other vulnerable populations get special assistance?\u003c/h2>\n\u003cp>According to health policy organization \u003ca href=\"https://justiceinaging.org/\">Justice in Aging\u003c/a>, seniors and those with disabilities have experienced higher rates of disenrollment from Medi-Cal. \u003ca href=\"https://www.dhcs.ca.gov/dataandstats/Pages/Continuous-Coverage-Eligibility-Unwinding-Dashboard.aspx\">Seniors, pregnant women, and certain children under 21\u003c/a> experienced a disenrollment rate of 26.7% in June 2023, compared to the overall average rate of 21%, according to the Department of Health Care Services.\u003c/p>\n\u003cp>Tiffany Huyenh-Cho, a health attorney at Justice in Aging, said seniors and people with disabilities are dual-eligible, which means they qualify for both Medicare and Medi-Cal.\u003c/p>\n\u003cp>“Dual-eligibles are a very diverse group with really high chronic needs, and they are more likely to be a person of color,” she said. “Their health disparities and chronic conditions are exacerbated by the loss of Medicaid.”\u003c/p>\n\u003cp>Often seniors and other dual-eligibles use their Medi-Cal benefits to cover their Medicare premiums as well as any wraparound services not included in Medicare. The loss of Medi-Cal means they may lose these additional benefits and face the deduction of Medicare premiums from their Social Security checks, said Huyenh-Cho.\u003c/p>\n\u003cp>“That puts people at risk of not being able to pay for rent and other needs, like clothing, food and utilities,” she said. “One of the big concerns that we have is it puts people at risk of economic insecurity and potentially at risk of homelessness because of that loss of income.”\u003c/p>\n\u003cp>Those who require additional assistance can reach out to \u003ca href=\"https://www.dhcs.ca.gov/services/medi-cal/eligibility/Pages/NavigatorsProject.aspx\">state-supported enrollment navigators\u003c/a>, which are community-based organizations and social service agencies that help vulnerable populations through the process.\u003c/p>\n\u003cp>The Department of Health Care Services has also released \u003ca href=\"https://socialpresskit.com/keep-medi-cal-coverage\">a social media toolkit\u003c/a> to spread awareness about redeterminations, so people can renew their coverage before they get disenrolled. This kit is available in 19 languages.\u003c/p>\n\u003cp>\u003cem>Supported by the California Health Care Foundation (CHCF), which works to ensure that people have access to the care they need, when they need it, at a price they can afford. Visit \u003ca href=\"https://www.chcf.org/\">www.chcf.org\u003c/a> to learn more.\u003c/em>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"excerpt": "About 300,000 Californians have lost Medi-Cal coverage since the state resumed eligibility checks. ",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cem>Lea este artículo en \u003ca href=\"https://calmatters.org/calmatters-en-espanol/2023/09/miles-de-californianos-pierden-medi-cal-cada-mes-que-puede-hacer-si-pierde-la-cobertura/\">español\u003c/a>.\u003c/em>\u003c/p>\n\u003cp>Tens of thousands of Californians are losing health insurance every month as the state resumes checking people’s eligibility for Medi-Cal, which it suspended during the COVID-19 public health emergency.\u003c/p>\n\u003cp>About 16 million people in California will be evaluated for eligibility from June 2023 to May 2024. About half of those up for a review were automatically renewed because officials were able to verify their information in the system. Others were sent yellow renewal packets that they were supposed to fill out and send back to their county Medi-Cal office.\u003c/p>\n\u003cp>More than 300,000 Californians have lost their Medi-Cal eligibility since July 1. The majority of lost coverage in June and July was due to procedural reasons, such as not sending their renewal forms back or having \u003ca href=\"https://www.dhcs.ca.gov/dataandstats/Pages/Continuous-Coverage-Eligibility-Unwinding-Dashboard.aspx\">incorrect information in their forms\u003c/a>, according to state data.\u003c/p>\n\u003cp>Some people losing coverage are no longer eligible because of changes in their personal lives, such as starting a job with higher pay. But some might see their coverage lapse because of paperwork mistakes or simply missing a notice in the mail.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“It’s because it’s been such a long period where folks have not had to renew their health coverage,” said Cary Sanders, senior policy director at the California Pan-Ethnic Health Network. “There could be up to 2 to 3 million Californians who could lose their health coverage just by virtue of this change, because there would be people who wouldn’t know what to do.”\u003c/p>\n\u003cp>Here are some answers to questions about what you can do if you lose coverage, including how to appeal.\u003c/p>\n\u003ch2>How do I know if I got disenrolled from Medi-Cal?\u003c/h2>\n\u003cp>You will get notified through mail. If you didn’t receive a notification but still believe you might have lost coverage, you can call your local Medi-Cal office to check eligibility or go to your regular clinic or hospital where they can look this information up for you.\u003c/p>\n\u003cp>For any questions about Medi-Cal eligibility, you can contact the state \u003ca href=\"https://www.dhcs.ca.gov/\">Department of Health Care Services\u003c/a>, which manages the Medi-Cal program. Its \u003ca href=\"https://www.dhcs.ca.gov/services/medi-cal/eligibility/Pages/Medi-Cal%20Eligibility%20Division.aspx\">Medi-Cal Eligibility Division\u003c/a> can be contacted at (916) 552-9200.\u003c/p>\n\u003ch2>I qualify for Medi-Cal but still got disenrolled. What should I do?\u003c/h2>\n\u003cp>Your next step depends on how much time has lapsed since you lost your coverage, as stated on the official notification letter.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>The state has instituted a 90-day appeal period in case you lost coverage even though you qualify.\u003c/p>\n\u003cp>If you are within the 90-day period, you should immediately fill out the yellow renewal packet, or supply any missing information, and send it to your county Medi-Cal office. If you lost the packet or sent the packet but still got disenrolled, call your local Medi-Cal office or go to your regular clinic or hospital to figure out the next steps.\u003c/p>\n\u003cp>If you are unable to send your information to your local Medi-Cal office due to accessibility issues and are running out of time, ask the office staff to accept your documents electronically or through the phone.\u003c/p>\n\u003cp>If you are past the 90-day period, you will be required to reapply for Medi-Cal benefits. This means starting a new application entirely.\u003c/p>\n\u003ch2>How can I appeal?\u003c/h2>\n\u003cp>Tatiana Fassieux, training and education specialist at Medicare advocacy nonprofit California Health Advocates, said people should remember that they have rights to appeal.\u003c/p>\n\u003cp>If you received a notification about disenrollment, you can request \u003ca href=\"https://www.dhcs.ca.gov/services/medi-cal/Pages/Medi-CalFairHearing.aspx\">a Fair Hearing\u003c/a> and appeal the loss of coverage. This will ensure that your benefits continue until the hearing is resolved.\u003c/p>\n\u003cp>“Many people take the letter verbatim and they don’t read it and they don’t appeal,” she said.\u003c/p>\n\u003cp>According to the state Department of Health Care Services, adults under the age of 26 or over age 50 can qualify for Medi-Cal regardless of immigration status. Medi-Cal does not share information with the immigration office, so undocumented Californians should not be afraid to seek help. Starting Jan. 1. Californians of all ages will be able to qualify for Medi-Cal irrespective of immigration status.\u003c/p>\n\u003ch2>I got disenrolled because I no longer qualify. How can I get health insurance?\u003c/h2>\n\u003cp>If you no longer qualify for Medi-Cal, you may still be able to get low-cost health insurance through \u003ca href=\"https://www.coveredca.com/\">Covered California,\u003c/a> which is the state’s marketplace for health insurance plans.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Those who earn up to 250% of the federal poverty level — or $33,975 for an individual or $69,375 for a family of four — would qualify for low-premium plans through Covered California. You may also be eligible for additional health insurance subsidies through \u003ca href=\"https://www.healthforcalifornia.com/covered-california?gclid=CjwKCAjwu4WoBhBkEiwAojNdXjuBHyXGv9QJ2WvwCQzjCMswHa1vsR1UuxKuTWc4ZI-l4ObZEcUNSxoCbQsQAvD_BwE\">the Affordable Care Act (ACA)\u003c/a>, including \u003ca href=\"https://www.irs.gov/affordable-care-act/individuals-and-families/the-premium-tax-credit-the-basics\">the Advance Premium Tax Credit\u003c/a> and \u003ca href=\"https://www.healthforcalifornia.com/covered-california/cost-sharing?gclid=CjwKCAjwu4WoBhBkEiwAojNdXm8haH2iO9JNelTbsVelQiCRS6uKUAGaOnFPfnOXFmDtuJX4TuxvahoCL8IQAvD_BwE\">Cost-Sharing Reduction plans\u003c/a>.\u003c/p>\n\u003cp>If you are over the age of 65 or have disabilities, you may also qualify for \u003ca href=\"https://www.medicare.gov/what-medicare-covers/your-medicare-coverage-choices/whats-medicare\">Medicare\u003c/a> (in addition), which can help pay for hospital costs, medical care and even prescription medication.\u003c/p>\n\u003ch2>How can I make sure I don’t get disenrolled in the future?\u003c/h2>\n\u003cp>Keep an eye out for any mail sent to you from your county Medi-Cal office. If you recently moved, make sure to update your address on the Medi-Cal website or by calling your local office.\u003c/p>\n\u003cp>You will be expected to renew and update your Medi-Cal coverage every year, so keep all your important information in an accessible place.\u003c/p>\n\u003cp>“You should have your documents like tax returns and health records handy,” Fassieux said.\u003c/p>\n\u003cp>You can \u003ca href=\"https://www.dhcs.ca.gov/pages/keep-your-medi-cal.aspx?utm_source=keepmedicalcoverage.org&utm_medium=referral&utm_campaign=keep-mc-coverage\">sign up\u003c/a> for renewal reminders through the state’s renewal website: keepmedicalcoverage.org. That resource also is \u003ca href=\"https://www.dhcs.ca.gov/Pages/mantenga-su-medi-cal.aspx\">available from the state in Spanish\u003c/a>.\u003c/p>\n\u003ch2>Are there any other resources I can use for help?\u003c/h2>\n\u003cp>The state’s Department of Health Care Services has several resources to help, including \u003ca href=\"https://www.dhcs.ca.gov/services/medi-cal/Pages/CountyOffices.aspx\">contact information for your local Medi-Cal office\u003c/a>, schedules of \u003ca href=\"https://www.dhcs.ca.gov/services/medi-cal/eligibility/Pages/Partner-Community-Events.aspx\">community events and health fairs\u003c/a> where you can get information in person, and guides on \u003ca href=\"https://www.dhcs.ca.gov/pages/keep-your-medi-cal.aspx\">what to do if you lost Medi-Cal coverage\u003c/a>.\u003c/p>\n\u003cp>For assistance with Medi-Cal re-enrollment, you also can call the Office of the Medi-Cal Ombudsman. The office is a neutral resource that can help you deal with any issues you may have with the program. You can contact \u003ca href=\"https://www.dhcs.ca.gov/services/medi-cal/Pages/MMCDOfficeoftheOmbudsman.aspx\">the Office of the Ombudsman\u003c/a> at (888) 452-8609.\u003c/p>\n\u003cp>There are also several third-party services that can help you get back on Medi-Cal.\u003c/p>\n\u003cp>\u003ca href=\"https://healthconsumer.org/\">Health Consumer Alliance\u003c/a> is a free assistance program funded by The California Endowment, Covered California, the state Department of Managed Health Care and the Blue Shield Foundation. It provides legal services and can help you renew your Medi-Cal coverage. To get in touch, you can read \u003ca href=\"https://healthconsumer.org/covid19/\">their guide on renewing Medi-Cal\u003c/a> or call their toll-free number, 888‑804‑3536.\u003c/p>\n\u003cp>You can contact \u003ca href=\"https://benefitscal.com/\">BenefitsCal\u003c/a> which also provides assistance with Medi-Cal. The website has translations in 20 languages.\u003c/p>\n\u003ch2>Will seniors and other vulnerable populations get special assistance?\u003c/h2>\n\u003cp>According to health policy organization \u003ca href=\"https://justiceinaging.org/\">Justice in Aging\u003c/a>, seniors and those with disabilities have experienced higher rates of disenrollment from Medi-Cal. \u003ca href=\"https://www.dhcs.ca.gov/dataandstats/Pages/Continuous-Coverage-Eligibility-Unwinding-Dashboard.aspx\">Seniors, pregnant women, and certain children under 21\u003c/a> experienced a disenrollment rate of 26.7% in June 2023, compared to the overall average rate of 21%, according to the Department of Health Care Services.\u003c/p>\n\u003cp>Tiffany Huyenh-Cho, a health attorney at Justice in Aging, said seniors and people with disabilities are dual-eligible, which means they qualify for both Medicare and Medi-Cal.\u003c/p>\n\u003cp>“Dual-eligibles are a very diverse group with really high chronic needs, and they are more likely to be a person of color,” she said. “Their health disparities and chronic conditions are exacerbated by the loss of Medicaid.”\u003c/p>\n\u003cp>Often seniors and other dual-eligibles use their Medi-Cal benefits to cover their Medicare premiums as well as any wraparound services not included in Medicare. The loss of Medi-Cal means they may lose these additional benefits and face the deduction of Medicare premiums from their Social Security checks, said Huyenh-Cho.\u003c/p>\n\u003cp>“That puts people at risk of not being able to pay for rent and other needs, like clothing, food and utilities,” she said. “One of the big concerns that we have is it puts people at risk of economic insecurity and potentially at risk of homelessness because of that loss of income.”\u003c/p>\n\u003cp>Those who require additional assistance can reach out to \u003ca href=\"https://www.dhcs.ca.gov/services/medi-cal/eligibility/Pages/NavigatorsProject.aspx\">state-supported enrollment navigators\u003c/a>, which are community-based organizations and social service agencies that help vulnerable populations through the process.\u003c/p>\n\u003cp>The Department of Health Care Services has also released \u003ca href=\"https://socialpresskit.com/keep-medi-cal-coverage\">a social media toolkit\u003c/a> to spread awareness about redeterminations, so people can renew their coverage before they get disenrolled. This kit is available in 19 languages.\u003c/p>\n\u003cp>\u003cem>Supported by the California Health Care Foundation (CHCF), which works to ensure that people have access to the care they need, when they need it, at a price they can afford. Visit \u003ca href=\"https://www.chcf.org/\">www.chcf.org\u003c/a> to learn more.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"slug": "its-worrisome-covered-california-announces-biggest-increase-in-premiums",
"title": "'It's Worrisome': Covered California Announces Biggest Increase in Premiums",
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"headTitle": "‘It’s Worrisome’: Covered California Announces Biggest Increase in Premiums | KQED",
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"content": "\u003cp>Premiums for health insurance sold through the state marketplace will increase by nearly 10% next year, the highest rate hike since 2018, \u003ca href=\"https://www.coveredca.com/newsroom/news-releases/2023/07/25/\">Covered California officials announced\u003c/a> Tuesday.\u003c/p>\n\u003cp>The projected 9.6% hike is the result of a “complicated time for health care,” Covered California Executive Director Jessica Altman said during a media briefing, but many Californians will be shielded from the increases as a result of federal and state financial assistance.\u003c/p>\n\u003cp>About 90% of enrollees qualify for some type of federal or state financial aid and 20% will see no change in their monthly premium, officials said. About 1.6 million Californians turn to the marketplace for health insurance, which offers plans that cost as little as $10 a month.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The rate increase, however, represents the return of a troubling trend: \u003ca href=\"https://calmatters.org/health/2022/07/rising-health-care-costs/\">runaway health care costs\u003c/a>, experts said.\u003c/p>\n\u003cp>“We’re seeing even larger increases in the private market. It’s worrisome,” said Anthony Wright, executive director of Health Access California, a consumer advocate group. “Individual consumers need health coverage and they need help now.”[pullquote size=\"medium\" align=\"right\" citation=\"Anthony Wright, executive director, Health Access California\"]‘We’re seeing even larger increases in the private market. It’s worrisome. Individual consumers need health coverage and they need help now.’[/pullquote]During the COVID-19 pandemic, an influx of $3 billion from the federal government helped dampen the effect of rising health care costs in California. Covered California premium increases held below 2% between 2020 and 2022.\u003c/p>\n\u003cp>The federal government extended assistance for two more years, but the 2024 increase reflects post-pandemic inflationary pressures, such as \u003ca href=\"https://calmatters.org/health/2023/05/cost-of-insulin/\">higher drug costs\u003c/a>, more people going to see the doctor, labor shortages and wage costs, Altman said.\u003c/p>\n\u003cp>The rate hikes vary by region, with more than one-third of enrollees potentially experiencing a double-digit increase, according to state data. Those who live in Mono, Inyo and Imperial counties may see the largest price increase at 15.8% compared to last year. Those same counties also experienced the \u003ca href=\"https://calmatters.org/health/2022/07/covered-california-rates/\">largest increase last year\u003c/a>.\u003c/p>\n\u003cp>“We’re glad that Covered California has federal and state subsidies to provide immediate help now, but we do need policymakers to double down on containing the costs of health care long-term,” Wright said. “This is a clarion call for the overall cost of health care going forward.”\u003c/p>\n\u003ch2>Covered California waives deductibles for many\u003c/h2>\n\u003cp>Last week, the \u003ca href=\"https://calmatters.org/newsletters/whatmatters/2023/07/california-cost-of-living-3/#wm-story-1\">Covered California board voted\u003c/a> to implement a plan that will make coverage more affordable for about 650,000 enrollees by eliminating their deductibles for the coming year.[aside postID=news_11949192 hero='https://ww2.kqed.org/app/uploads/sites/10/2023/05/IMG_0196-1-1020x765.jpg']The vote capped a \u003ca href=\"https://calmatters.org/health/2023/05/covered-california-cost/\">drawn-out budget battle\u003c/a> between Gov. Gavin Newsom, legislators and health care consumer advocates who have \u003ca href=\"https://calmatters.org/health/2023/02/health-care-costs/\">criticized Newsom\u003c/a> for repeatedly moving money intended for health care subsidies into the state’s general fund.\u003c/p>\n\u003cp>Under the plan, deductibles will be eliminated for individuals earning as much as $33,975 annually and families earning up to $69,375 annually. Previously, people with those plans paid deductibles of up to $5,400. The new plan also significantly reduces out-of-pocket copays for doctor visits and prescription drugs.\u003c/p>\n\u003cp>“Despite the rate increase, Californians who enroll in health care coverage through Covered California will benefit from the greatest level of financial support ever offered … as we head into 2024,” Altman said.\u003c/p>\n\u003ch2>‘Hefty’ health insurance increase\u003c/h2>\n\u003cp>Christine Eibner, a senior economist with the RAND Corporation, a research and policy think tank, called the state’s projected premium increase “hefty.”[aside label='More on Health Care' tag='health-care']“There will be some sliver of people who will have to pay the full cost,” Eibner said. “A lot of people are protected so maybe they don’t care, but who is paying? Ultimately it’s the taxpayer.”\u003c/p>\n\u003cp>A significant number of people who are no longer eligible for Medi-Cal, the state’s public insurance program for individuals with very low-income, also are expected to enroll in Covered California, which could drive future cost increases.\u003c/p>\n\u003cp>“That population is relatively expensive,” Eibner said. “People who are lower income have more health care issues, and bringing them into the market may lead to higher premiums.”\u003c/p>\n\u003cp>The state paused \u003ca href=\"https://calmatters.org/health/2023/07/medi-cal-eligibility-california-review/\">checking people for Medi-Cal eligibility\u003c/a> during the federal COVID-19 public health emergency, but about 225,000 Californians have been kicked off since the state resumed monthly reviews this year. Covered California’s enrollment period runs from November through the end of January.\u003c/p>\n\u003cp>\u003c/p>\n",
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"excerpt": "California still offers generous subsidies, but the rate hike signals that runaway health care costs are back after 5 years of low premium increases.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Premiums for health insurance sold through the state marketplace will increase by nearly 10% next year, the highest rate hike since 2018, \u003ca href=\"https://www.coveredca.com/newsroom/news-releases/2023/07/25/\">Covered California officials announced\u003c/a> Tuesday.\u003c/p>\n\u003cp>The projected 9.6% hike is the result of a “complicated time for health care,” Covered California Executive Director Jessica Altman said during a media briefing, but many Californians will be shielded from the increases as a result of federal and state financial assistance.\u003c/p>\n\u003cp>About 90% of enrollees qualify for some type of federal or state financial aid and 20% will see no change in their monthly premium, officials said. About 1.6 million Californians turn to the marketplace for health insurance, which offers plans that cost as little as $10 a month.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The rate increase, however, represents the return of a troubling trend: \u003ca href=\"https://calmatters.org/health/2022/07/rising-health-care-costs/\">runaway health care costs\u003c/a>, experts said.\u003c/p>\n\u003cp>“We’re seeing even larger increases in the private market. It’s worrisome,” said Anthony Wright, executive director of Health Access California, a consumer advocate group. “Individual consumers need health coverage and they need help now.”\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>During the COVID-19 pandemic, an influx of $3 billion from the federal government helped dampen the effect of rising health care costs in California. Covered California premium increases held below 2% between 2020 and 2022.\u003c/p>\n\u003cp>The federal government extended assistance for two more years, but the 2024 increase reflects post-pandemic inflationary pressures, such as \u003ca href=\"https://calmatters.org/health/2023/05/cost-of-insulin/\">higher drug costs\u003c/a>, more people going to see the doctor, labor shortages and wage costs, Altman said.\u003c/p>\n\u003cp>The rate hikes vary by region, with more than one-third of enrollees potentially experiencing a double-digit increase, according to state data. Those who live in Mono, Inyo and Imperial counties may see the largest price increase at 15.8% compared to last year. Those same counties also experienced the \u003ca href=\"https://calmatters.org/health/2022/07/covered-california-rates/\">largest increase last year\u003c/a>.\u003c/p>\n\u003cp>“We’re glad that Covered California has federal and state subsidies to provide immediate help now, but we do need policymakers to double down on containing the costs of health care long-term,” Wright said. “This is a clarion call for the overall cost of health care going forward.”\u003c/p>\n\u003ch2>Covered California waives deductibles for many\u003c/h2>\n\u003cp>Last week, the \u003ca href=\"https://calmatters.org/newsletters/whatmatters/2023/07/california-cost-of-living-3/#wm-story-1\">Covered California board voted\u003c/a> to implement a plan that will make coverage more affordable for about 650,000 enrollees by eliminating their deductibles for the coming year.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>The vote capped a \u003ca href=\"https://calmatters.org/health/2023/05/covered-california-cost/\">drawn-out budget battle\u003c/a> between Gov. Gavin Newsom, legislators and health care consumer advocates who have \u003ca href=\"https://calmatters.org/health/2023/02/health-care-costs/\">criticized Newsom\u003c/a> for repeatedly moving money intended for health care subsidies into the state’s general fund.\u003c/p>\n\u003cp>Under the plan, deductibles will be eliminated for individuals earning as much as $33,975 annually and families earning up to $69,375 annually. Previously, people with those plans paid deductibles of up to $5,400. The new plan also significantly reduces out-of-pocket copays for doctor visits and prescription drugs.\u003c/p>\n\u003cp>“Despite the rate increase, Californians who enroll in health care coverage through Covered California will benefit from the greatest level of financial support ever offered … as we head into 2024,” Altman said.\u003c/p>\n\u003ch2>‘Hefty’ health insurance increase\u003c/h2>\n\u003cp>Christine Eibner, a senior economist with the RAND Corporation, a research and policy think tank, called the state’s projected premium increase “hefty.”\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>“There will be some sliver of people who will have to pay the full cost,” Eibner said. “A lot of people are protected so maybe they don’t care, but who is paying? Ultimately it’s the taxpayer.”\u003c/p>\n\u003cp>A significant number of people who are no longer eligible for Medi-Cal, the state’s public insurance program for individuals with very low-income, also are expected to enroll in Covered California, which could drive future cost increases.\u003c/p>\n\u003cp>“That population is relatively expensive,” Eibner said. “People who are lower income have more health care issues, and bringing them into the market may lead to higher premiums.”\u003c/p>\n\u003cp>The state paused \u003ca href=\"https://calmatters.org/health/2023/07/medi-cal-eligibility-california-review/\">checking people for Medi-Cal eligibility\u003c/a> during the federal COVID-19 public health emergency, but about 225,000 Californians have been kicked off since the state resumed monthly reviews this year. Covered California’s enrollment period runs from November through the end of January.\u003c/p>\n\u003cp>\u003c/p>\n\u003c/div>\u003c/p>",
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"title": "For Many Long COVID Patients, Qualifying for Disability Is Half the Battle",
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"content": "\u003cp>Chris Pham contracted COVID-19 at the onset of the pandemic, in March 2020, and just couldn’t kick it.\u003c/p>\n\u003cp>“I was two weeks in, and the first time that I realized something was really wrong was when I decided to take a run,” said the now-35-year-old, who had been living in the Bay Area in good health and was training for a triathlon. “I was feeling a little bit better. … But after mile 1, I can remember really thinking, ‘Wow, there’s something that’s totally wrong with my body.’ And I broke into a cold sweat and I just couldn’t run anymore.”\u003c/p>\n\u003cp>Pham said his doctors, who at that point still knew very little about the virus, struggled to explain and diagnose his condition, which is now clearly understood to be what’s known as long COVID. “My doctors didn’t have any data really to base a diagnosis off of,” he said. “So, yeah, I was given the runaround or not really believed. And that was a scary, scary thing in and of itself.”[aside postID=news_11950643 hero='https://ww2.kqed.org/app/uploads/sites/10/2023/05/RS65622_005_KQED_LongCOVIDCharlieMcCone_05182023-qut-1020x680.jpg']Pham said he generally learned how to manage his symptoms, but was often overwhelmed with paralyzing fatigue. He eventually tried to return to work full-time, as the head of sales of a Bay Area start-up, but found it nearly impossible to get through the day.\u003c/p>\n\u003cp>“I was passing out in the middle of the day after one or two meetings and it would cause and trigger my long COVID symptoms,” he said. “On calls, there was extreme fatigue and then this pain, like heavy sinking pain. Just like someone attached a 50-pound anchor to your face and let it drop to the bottom of the ocean.”\u003c/p>\n\u003cp>Pham had to take medical leave, and was ultimately laid off. But after his initial disability payments petered out, he struggled to secure the long-term disability benefits he needed to pay for basic living expenses and medical care.\u003c/p>\n\u003cp>Fast-forward more than three years: Pham still suffers from debilitating symptoms stemming from his initial infection — among the estimated millions of long COVID patients in the U.S. — and says applying for and receiving the payments has been a constant struggle.\u003c/p>\n\u003cp>“The process was extremely difficult to receive the funds, even though it was approved. The disability company would often come back and say, ‘It needs a review.’ And this happened every single month,” Pham said of his initial efforts to apply for long-term disability, noting that his insurance company often required him to do additional testing to prove his eligibility. “So I had no certainty on how to plan. I was basically chasing down my benefits the whole time.”\u003c/p>\n\u003cfigure id=\"attachment_11952470\" class=\"wp-caption alignnone\" style=\"max-width: 1920px\">\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/10/2023/06/060723-Chris-Pham-KQED.jpg\">\u003cimg decoding=\"async\" loading=\"lazy\" class=\"wp-image-11952470 size-full\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/06/060723-Chris-Pham-KQED.jpg\" alt=\"A young Asian man in a gray T-shirt rests on a brown leather couch with his eyes closed.\" width=\"1920\" height=\"1280\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2023/06/060723-Chris-Pham-KQED.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/10/2023/06/060723-Chris-Pham-KQED-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/10/2023/06/060723-Chris-Pham-KQED-1020x680.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/10/2023/06/060723-Chris-Pham-KQED-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/10/2023/06/060723-Chris-Pham-KQED-1536x1024.jpg 1536w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Chris Pham rests on the couch at his parents’ house in Arizona, where he now lives. \u003ccite>(Courtesy Chris Pham)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Pham’s insurance company eventually terminated his long-term benefits, and with no source of income, he was forced to move back in with his parents in Arizona.\u003c/p>\n\u003cp>“If I didn’t have the support of my family, I’d be out on the streets,” he said. “[Insurers] are willing to let all the folks with long COVID who are currently suffering go without the benefits that are rightly owed to them.”\u003c/p>\n\u003cp>His insurance company, Guardian, did not return KQED’s request for comment about his case.\u003c/p>\n\u003cp>A big part of the problem for patients: There’s no single definition of long COVID and no singular test to determine whether someone has it, making it easier for insurance companies to deny claims.[pullquote align=\"right\" size=\"medium\" citation=\"Chris Pham, long COVID patient\"]‘If I didn’t have the support of my family, I’d be out on the streets.’[/pullquote]“I would urge the CDC and the World Health Organization [to] encourage a clinical diagnosis of long COVID,” said David Putrino, a physical therapist at Mount Sinai Health System in New York, who has worked with thousands of long COVID patients over the last three years.\u003c/p>\n\u003cp>“[T]he payers and the people denying benefits to people with long COVID always say the same thing: ‘Oh, you don’t have enough evidence. We don’t have an objective test to prove that you’re sick,’” he said. “Please let us stop asking sick people to prove to us that they’re sick.”\u003c/p>\n\u003cp>Pham spent months fighting with Guardian to reinstate his long-term disability payments, and finally won his appeal in January.\u003c/p>\n\u003cp>Cassie Springer Ayeni, Pham’s attorney who helped wage his protracted legal challenge, says securing such benefits can be a lifesaver for people with long COVID.\u003c/p>\n\u003cfigure id=\"attachment_11952494\" class=\"wp-caption alignnone\" style=\"max-width: 1920px\">\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/10/2023/06/RS66047_005_KQED_CassieSpringerAyeniLongCovid_06052023-qut-1.jpg\">\u003cimg decoding=\"async\" loading=\"lazy\" class=\"wp-image-11952494 size-full\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/06/RS66047_005_KQED_CassieSpringerAyeniLongCovid_06052023-qut-1.jpg\" alt=\"A middle-aged white woman with glasses, wearing a business jacket, holds a large stack of papers. \" width=\"1920\" height=\"1280\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2023/06/RS66047_005_KQED_CassieSpringerAyeniLongCovid_06052023-qut-1.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/10/2023/06/RS66047_005_KQED_CassieSpringerAyeniLongCovid_06052023-qut-1-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/10/2023/06/RS66047_005_KQED_CassieSpringerAyeniLongCovid_06052023-qut-1-1020x680.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/10/2023/06/RS66047_005_KQED_CassieSpringerAyeniLongCovid_06052023-qut-1-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/10/2023/06/RS66047_005_KQED_CassieSpringerAyeniLongCovid_06052023-qut-1-1536x1024.jpg 1536w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Cassie Springer Ayeni, a disability attorney in San Leandro who works with many long COVID patients, shows a thick stack of her client’s disability claims, on June 5, 2023.\u003c/figcaption>\u003c/figure>\n\u003cp>“These benefits typically do last through age 67 for people who are affected by long COVID or any other disabling condition,” she said, noting that half of her new clients suffer from long COVID. “That’s why they’re so valuable — because this is potentially income for somebody who might not be able to ever return to the workforce.”\u003c/p>\n\u003cp>Springer Ayeni says such uncertainty leaves many people with long COVID in both a physical and financial bind.\u003c/p>\n\u003cp>“People take loans and people take loans from family. And because of the cost of living in the Bay Area, a lot of my clients wind up selling their house, moving somewhere else,” she said. “I’ve had two clients just in the last year have to give up living in the Bay Area because of their disabilities, because they can’t live off of an unreliable source of income.”\u003c/p>\n\u003cp>The true economic cost of long COVID in the United States likely won’t be fully realized for years, if ever, particularly because the U.S. has done a poor overall job of tracking the condition, said Katie Bach, senior fellow at the Brookings Institution.[pullquote align=\"right\" size=\"medium\" citation=\"Katie Bach, senior fellow, Brookings Institution\"]‘My best estimate is that we have millions of full-time-equivalent workers not working and out of the labor force due to long COVID.’[/pullquote]“My best estimate is that we have millions of full-time-equivalent workers not working and out of the labor force due to long COVID. So that’s somewhere between $100 billion and $230 billion a year in lost wages,” she said. “This is not the first post-viral illness that we have seen in the U.S. We’ve just never seen an outbreak of this scale.”\u003c/p>\n\u003cp>But from an insurer’s perspective, long COVID poses a number of major issues, says Linda Bergthold, a health policy consultant and researcher. She says one of the biggest issues is that there have been no diagnostic codes for long COVID. Those codes, which doctors have to denote when requesting coverage for their patients, are a key part of the claims process. And because there are so many symptoms associated with the condition — from fatigue to heart issues — some of the codes don’t necessarily cover the health problems that a long COVID patient might be experiencing.\u003c/p>\n\u003cp>Additionally, she said, insurance companies have a notorious history — one far predating COVID — of denying treatment claims they do not deem a “medical necessity.” That vague benchmark has proved particularly detrimental to long COVID patients seeking new treatments that have not yet been scientifically proven — and that insurance companies often consider unnecessary.\u003c/p>\n\u003cp>Although Chris Pham won his appeal for disability benefits, he says he still struggles on a day-to-day basis.\u003c/p>\n\u003cp>“I don’t have the ability to provide for myself,” he said. “I don’t [even] have the ability to do the dishes.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Pham said he generally learned how to manage his symptoms, but was often overwhelmed with paralyzing fatigue. He eventually tried to return to work full-time, as the head of sales of a Bay Area start-up, but found it nearly impossible to get through the day.\u003c/p>\n\u003cp>“I was passing out in the middle of the day after one or two meetings and it would cause and trigger my long COVID symptoms,” he said. “On calls, there was extreme fatigue and then this pain, like heavy sinking pain. Just like someone attached a 50-pound anchor to your face and let it drop to the bottom of the ocean.”\u003c/p>\n\u003cp>Pham had to take medical leave, and was ultimately laid off. But after his initial disability payments petered out, he struggled to secure the long-term disability benefits he needed to pay for basic living expenses and medical care.\u003c/p>\n\u003cp>Fast-forward more than three years: Pham still suffers from debilitating symptoms stemming from his initial infection — among the estimated millions of long COVID patients in the U.S. — and says applying for and receiving the payments has been a constant struggle.\u003c/p>\n\u003cp>“The process was extremely difficult to receive the funds, even though it was approved. The disability company would often come back and say, ‘It needs a review.’ And this happened every single month,” Pham said of his initial efforts to apply for long-term disability, noting that his insurance company often required him to do additional testing to prove his eligibility. “So I had no certainty on how to plan. I was basically chasing down my benefits the whole time.”\u003c/p>\n\u003cfigure id=\"attachment_11952470\" class=\"wp-caption alignnone\" style=\"max-width: 1920px\">\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/10/2023/06/060723-Chris-Pham-KQED.jpg\">\u003cimg decoding=\"async\" loading=\"lazy\" class=\"wp-image-11952470 size-full\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/06/060723-Chris-Pham-KQED.jpg\" alt=\"A young Asian man in a gray T-shirt rests on a brown leather couch with his eyes closed.\" width=\"1920\" height=\"1280\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2023/06/060723-Chris-Pham-KQED.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/10/2023/06/060723-Chris-Pham-KQED-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/10/2023/06/060723-Chris-Pham-KQED-1020x680.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/10/2023/06/060723-Chris-Pham-KQED-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/10/2023/06/060723-Chris-Pham-KQED-1536x1024.jpg 1536w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Chris Pham rests on the couch at his parents’ house in Arizona, where he now lives. \u003ccite>(Courtesy Chris Pham)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Pham’s insurance company eventually terminated his long-term benefits, and with no source of income, he was forced to move back in with his parents in Arizona.\u003c/p>\n\u003cp>“If I didn’t have the support of my family, I’d be out on the streets,” he said. “[Insurers] are willing to let all the folks with long COVID who are currently suffering go without the benefits that are rightly owed to them.”\u003c/p>\n\u003cp>His insurance company, Guardian, did not return KQED’s request for comment about his case.\u003c/p>\n\u003cp>A big part of the problem for patients: There’s no single definition of long COVID and no singular test to determine whether someone has it, making it easier for insurance companies to deny claims.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>“I would urge the CDC and the World Health Organization [to] encourage a clinical diagnosis of long COVID,” said David Putrino, a physical therapist at Mount Sinai Health System in New York, who has worked with thousands of long COVID patients over the last three years.\u003c/p>\n\u003cp>“[T]he payers and the people denying benefits to people with long COVID always say the same thing: ‘Oh, you don’t have enough evidence. We don’t have an objective test to prove that you’re sick,’” he said. “Please let us stop asking sick people to prove to us that they’re sick.”\u003c/p>\n\u003cp>Pham spent months fighting with Guardian to reinstate his long-term disability payments, and finally won his appeal in January.\u003c/p>\n\u003cp>Cassie Springer Ayeni, Pham’s attorney who helped wage his protracted legal challenge, says securing such benefits can be a lifesaver for people with long COVID.\u003c/p>\n\u003cfigure id=\"attachment_11952494\" class=\"wp-caption alignnone\" style=\"max-width: 1920px\">\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/10/2023/06/RS66047_005_KQED_CassieSpringerAyeniLongCovid_06052023-qut-1.jpg\">\u003cimg decoding=\"async\" loading=\"lazy\" class=\"wp-image-11952494 size-full\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/06/RS66047_005_KQED_CassieSpringerAyeniLongCovid_06052023-qut-1.jpg\" alt=\"A middle-aged white woman with glasses, wearing a business jacket, holds a large stack of papers. \" width=\"1920\" height=\"1280\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2023/06/RS66047_005_KQED_CassieSpringerAyeniLongCovid_06052023-qut-1.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/10/2023/06/RS66047_005_KQED_CassieSpringerAyeniLongCovid_06052023-qut-1-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/10/2023/06/RS66047_005_KQED_CassieSpringerAyeniLongCovid_06052023-qut-1-1020x680.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/10/2023/06/RS66047_005_KQED_CassieSpringerAyeniLongCovid_06052023-qut-1-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/10/2023/06/RS66047_005_KQED_CassieSpringerAyeniLongCovid_06052023-qut-1-1536x1024.jpg 1536w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Cassie Springer Ayeni, a disability attorney in San Leandro who works with many long COVID patients, shows a thick stack of her client’s disability claims, on June 5, 2023.\u003c/figcaption>\u003c/figure>\n\u003cp>“These benefits typically do last through age 67 for people who are affected by long COVID or any other disabling condition,” she said, noting that half of her new clients suffer from long COVID. “That’s why they’re so valuable — because this is potentially income for somebody who might not be able to ever return to the workforce.”\u003c/p>\n\u003cp>Springer Ayeni says such uncertainty leaves many people with long COVID in both a physical and financial bind.\u003c/p>\n\u003cp>“People take loans and people take loans from family. And because of the cost of living in the Bay Area, a lot of my clients wind up selling their house, moving somewhere else,” she said. “I’ve had two clients just in the last year have to give up living in the Bay Area because of their disabilities, because they can’t live off of an unreliable source of income.”\u003c/p>\n\u003cp>The true economic cost of long COVID in the United States likely won’t be fully realized for years, if ever, particularly because the U.S. has done a poor overall job of tracking the condition, said Katie Bach, senior fellow at the Brookings Institution.\u003c/p>\u003c/div>",
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"content": "‘My best estimate is that we have millions of full-time-equivalent workers not working and out of the labor force due to long COVID.’",
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"content": "\u003cdiv class=\"post-body\">\u003cp>“My best estimate is that we have millions of full-time-equivalent workers not working and out of the labor force due to long COVID. So that’s somewhere between $100 billion and $230 billion a year in lost wages,” she said. “This is not the first post-viral illness that we have seen in the U.S. We’ve just never seen an outbreak of this scale.”\u003c/p>\n\u003cp>But from an insurer’s perspective, long COVID poses a number of major issues, says Linda Bergthold, a health policy consultant and researcher. She says one of the biggest issues is that there have been no diagnostic codes for long COVID. Those codes, which doctors have to denote when requesting coverage for their patients, are a key part of the claims process. And because there are so many symptoms associated with the condition — from fatigue to heart issues — some of the codes don’t necessarily cover the health problems that a long COVID patient might be experiencing.\u003c/p>\n\u003cp>Additionally, she said, insurance companies have a notorious history — one far predating COVID — of denying treatment claims they do not deem a “medical necessity.” That vague benchmark has proved particularly detrimental to long COVID patients seeking new treatments that have not yet been scientifically proven — and that insurance companies often consider unnecessary.\u003c/p>\n\u003cp>Although Chris Pham won his appeal for disability benefits, he says he still struggles on a day-to-day basis.\u003c/p>\n\u003cp>“I don’t have the ability to provide for myself,” he said. “I don’t [even] have the ability to do the dishes.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>The adage “get it in writing” applies to politics as much as anything else, and it would seem the California Legislature could learn a lesson or two.\u003c/p>\n\u003cp>Legislators and advocates have been pushing Gov. Gavin Newsom since last year to make good on a \u003ca href=\"https://calmatters.org/health/2023/02/health-care-costs/\">longtime promise\u003c/a> to funnel money from a controversial tax penalty into the Covered California marketplace, making health insurance cheaper for nearly 1 million enrollees. The problem — or at least the argument Newsom has always made — is that state statute doesn’t require the penalty money to be used on health care. It goes directly into the general fund — where it has stayed for most of the past four years.[pullquote size=\"medium\" align=\"right\" citation=\"Assemblymember Joaquin Arambula\"]‘I’m trying to make sure that those dollars stay in this area to address affordability, and I’m not hearing from the administration that same commitment.’[/pullquote]\u003c/p>\n\u003cp>But legislators say that’s not what they intended when they voted on the measure in 2019. Senate leadership signaled its intent last week to ensure in writing that the money will “further lower the costs of health coverage for lower- and middle-income Californians” moving forward. The \u003ca href=\"https://sbud.senate.ca.gov/sites/sbud.senate.ca.gov/files/Protect%20Our%20Progress%20Senate%20Budget%20Plan.pdf\">Senate budget proposal rejects Newsom’s plan (PDF)\u003c/a> to temporarily move $333.4 million in penalty money from an affordability reserve to the general fund, calling it a “rip-off” of Covered California funds.\u003c/p>\n\u003cp>“Our plan protects important advancements that California has made that has moved us towards a more equitable and sustainable economy,” Senate Budget Chair \u003ca href=\"https://calmatters.org/legislator-tracker/nancy-skinner-1954/\">Nancy Skinner\u003c/a> said during a press briefing last week.\u003c/p>\n\u003cp>In 2019, Newsom proposed and the Legislature passed a polarizing tax penalty on Californians without health insurance, known as the individual mandate, with verbal assurances that it would be used to lower health care costs for those who have insurance through Covered California, the state version of the Affordable Care Act marketplace. Though \u003ca href=\"https://californiahealthline.org/news/article/health-insurance-mandate-penalties/\">more than $1 billion has been collected in the past four years\u003c/a>, the money has only been used once to lower costs for enrollees, about $355 million in 2020.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The \u003ca href=\"https://sbud.senate.ca.gov/sites/sbud.senate.ca.gov/files/Protect%20Our%20Progress%20Senate%20Budget%20Plan.pdf\">Senate Democrats’ budget proposal (PDF)\u003c/a>, which relies on corporate tax hikes that \u003ca href=\"https://calmatters.org/newsletters/whatmatters/2023/04/california-taxes-budget/\">Newsom swiftly rejected\u003c/a> to avoid a variety of cuts, \u003ca href=\"https://calmatters.org/commentary/2023/05/democrats-at-odds-budget-deficit/\">sets the stage for an intense period of negotiation\u003c/a> between the Legislature and governor as they hash out a state spending plan in the face of diminishing tax revenue. The Senate’s counter proposal would mandate using the money to eliminate deductibles and copays for roughly 900,000 Covered California enrollees next year. It’s one of several health care funding battles heating up amid a bleak budget year, including a fight to infuse emergency cash into \u003ca href=\"https://calmatters.org/health/2023/04/hospital-closures-california/\">hospitals on the brink of closure\u003c/a>.\u003c/p>\n\u003cp>Newsom is expected to disclose later this month an even more dismal financial picture for the state than the \u003ca href=\"https://calmatters.org/california-budget/2023/01/california-budget-newsom-deficit/\">$22.5 billion deficit he projected in his January budget proposal\u003c/a>.\u003c/p>\n\u003cp>In a statement, Brandon Richards, spokesperson for Newsom, said the governor will “continue to work with the California Legislature to develop the final budget package” in the coming months.\u003c/p>\n\u003cp>This is just one step in a long budget negotiation that will stretch to June. If the Senate’s counterproposal makes it into the state’s final budget come summer, leadership intends to end the diversion of penalty money permanently. Notably, Democratic leaders from the Assembly have not endorsed the Senate’s spending plan nor put forth their own proposal, but John Casey, communications director for Assembly Speaker Anthony Rendon, said both houses are interested in the issue.\u003c/p>\n\u003cp>“We’ll see what the May revision includes and the two houses will advance their priorities as best they can in negotiations afterward,” Casey said.\u003c/p>\n\u003ch2>‘A bitter pill’\u003c/h2>\n\u003cp>In recent committee hearings, Assembly and Senate legislators have lambasted this particular proposal in Newsom’s budget.\u003c/p>\n\u003cp>“I’m trying to make sure that those dollars stay in this area to address affordability, and I’m not hearing from the administration that same commitment,” said Assemblymember \u003ca href=\"https://calmatters.org/legislator-tracker/joaquin-arambula-1977/\">Joaquin Arambula\u003c/a>, a Fresno Democrat and chairperson of the Assembly budget subcommittee on health.[aside postID=\"news_11944543,news_11944091\" label=\"Related Posts\"]Sen. \u003ca href=\"https://calmatters.org/legislator-tracker/caroline-menjivar-1989/\">Caroline Menjivar\u003c/a>, a newly elected Democrat from Van Nuys and chairperson of the Senate budget subcommittee on health, criticized the governor’s plan for saving money “on the backs of our low-income communities.”\u003c/p>\n\u003cp>On his first day in office, Newsom proposed reinstating a tax on people without health insurance to fund increased subsidies for people who have Covered California insurance. A previous \u003ca href=\"https://www.cnbc.com/2018/01/30/trump-touts-repeal-of-obamacare-individual-mandate.html\">federal version of the tax had been repealed by the Trump administration\u003c/a> the year prior, which contributed to a \u003ca href=\"https://hbex.coveredca.com/financial-reports/PDFs/2019/fy-2019-20-annual-report-final.pdf\">24% drop in enrollment in Covered California plans (PDF)\u003c/a>.\u003c/p>\n\u003cp>New taxes always trigger a \u003ca href=\"https://www.capradio.org/articles/2019/02/21/californias-individual-mandate-a-fix-for-a-broken-system-or-a-penalty-on-the-poor/\">legislative skirmish\u003c/a>, but this one gave even Democratic lawmakers and powerful advocacy groups pause: Theoretically, the tax would encourage more people to get health insurance, lowering the overall cost for everyone in the marketplace, but the penalty would come out of the pockets of the state’s poorest residents — those who forego insurance because it’s too expensive.\u003c/p>\n\u003cp>The Legislature ultimately approved the tax in 2019 with the understanding that the projected $1.4 billion in revenue over three years would be used to lower insurance costs.\u003c/p>\n\u003cp>The majority of that money, however, has stayed in the state’s general fund. Newsom has previously argued that the federal government’s more generous COVID-19 subsidies, which extend through 2025, render additional state spending unnecessary, especially at a time when California faces a growing deficit.\u003c/p>\n\u003cp>But legislators in both the Senate and the Assembly say that’s not what they voted for.\u003c/p>\n\u003cp>“The individual mandate was not intended to create funds for other government programs outside of health care from my perspective,” Assemblymember \u003ca href=\"https://calmatters.org/legislator-tracker/jim-wood-1960/\">Jim Wood\u003c/a> said during a recent budget subcommittee meeting. “I don’t think I would have supported it if that was the way I thought it would end up.”\u003c/p>\n\u003cp>Wood, a Democrat from Santa Rosa who leads the Assembly Health Committee, called the diversion to the general fund “a bitter pill to swallow.”\u003c/p>\n\u003cp>During the hearing, Department of Finance analyst Matt Aguilera argued using the money to alleviate the deficit would not impact current services under Covered California.\u003c/p>\n\u003cp>“Everybody is concerned about affordability. There’s agreement on that. Just due to the economic situation this may not be a good time to start up new programs,” Aguilera said.\u003c/p>\n\u003cp>But advocates argue using the revenue from the individual mandate penalty wouldn’t be new spending. It would be fulfilling an existing commitment.\u003c/p>\n\u003ch2>Costs keep rising\u003c/h2>\n\u003cp>Last year, in tandem with \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=202120220SB944\">a measure to ensure the penalty money no longer got diverted\u003c/a>, the Covered California board approved a plan to eliminate deductibles for the state’s \u003ca href=\"https://www.healthforcalifornia.com/covered-california/plans?gclid=CjwKCAjwxr2iBhBJEiwAdXECw-W0XW5KoSAgoaM1h7Q2V7Khe0nQuGMOs73i3BBK8Mnu7fhFl6vjzRoC-wIQAvD_BwE\">mid-tier coverage option\u003c/a>, which is widely considered the most cost-effective insurance option. When \u003ca href=\"https://www.gov.ca.gov/wp-content/uploads/2022/09/SB-944-veto-message.pdf?emrc=af81f2\">Newsom vetoed the policy bill (PDF)\u003c/a>, citing a “downturn in revenues,” the plan was abandoned.\u003c/p>\n\u003cp>“Last year this was a priority for everybody: the health plans, business groups, both the Assembly and Senate prioritized it in their budgets, health advocates, Covered California itself. Everybody lined up to support this,” said Rachel Linn Gish, communications director for Health Access California, a consumer advocacy lobbying group. “The only person we didn’t have was the governor.”\u003c/p>\n\u003cp>Instead, \u003ca href=\"https://www.coveredca.com/pdfs/2022-Health-Benefits-table.pdf\">deductibles jumped from $3,700 for an individual and $7,400 for a family with a mid-tier plan (PDF)\u003c/a> to \u003ca href=\"https://www.coveredca.com/pdfs/Health-Benefits-table.pdf\">$4,750 and $9,500, respectively (PDF)\u003c/a>. Health Access is sponsoring \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=202320240AB1208\">another measure\u003c/a> this year to ensure money appropriated for Covered California affordability measures is used for that purpose.\u003c/p>\n\u003cp>\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe loading=\"lazy\" src=\"https://flo.uri.sh/visualisation/12755159/embed?auto=1\" width=\"800\" height=\"550\" scrolling=\"yes\" class=\"iframe-class\" frameborder=\"0\">\u003c/iframe>\u003c/p>\n\u003cp>“One of the most direct and impactful ways we can make sure consumers get health care access right now is by lowering the cost of care,” Linn Gish said. “The 2025 (federal subsidy) sunset was the governor’s main sticking point … but to us, it’s 2023. Why can’t we help people now?”\u003c/p>\n\u003cp>Senate Democrats also rejected delays and cuts to investments in the state’s health care workforce, including a $49.8 million cut to training programs for public health workers. Michelle Gibbons, executive director of the County Health Executives Association of California, said the money was sorely needed after decades of public health budget cuts left the state scrambling to respond to the COVID-19 pandemic.\u003c/p>\n\u003cp>“We can’t even begin to grow the pipeline of microbiologists, lab directors, epidemiologists — very skilled positions — without these programs and investments,” Gibbons said.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>It’s unclear, however, how feasible the Senate Democrats’ proposal is with the state facing an economic downturn. Most of the cuts avoided are funded through a $6 billion proposed corporate tax hike and $5 billion suspension of a major tax credit, which \u003ca href=\"https://calmatters.org/newsletters/whatmatters/2023/04/california-taxes-budget/\">Newsom rejected within hours of the proposal’s release\u003c/a>.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>The adage “get it in writing” applies to politics as much as anything else, and it would seem the California Legislature could learn a lesson or two.\u003c/p>\n\u003cp>Legislators and advocates have been pushing Gov. Gavin Newsom since last year to make good on a \u003ca href=\"https://calmatters.org/health/2023/02/health-care-costs/\">longtime promise\u003c/a> to funnel money from a controversial tax penalty into the Covered California marketplace, making health insurance cheaper for nearly 1 million enrollees. The problem — or at least the argument Newsom has always made — is that state statute doesn’t require the penalty money to be used on health care. It goes directly into the general fund — where it has stayed for most of the past four years.\u003c/p>\u003c/div>",
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"content": "‘I’m trying to make sure that those dollars stay in this area to address affordability, and I’m not hearing from the administration that same commitment.’",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>But legislators say that’s not what they intended when they voted on the measure in 2019. Senate leadership signaled its intent last week to ensure in writing that the money will “further lower the costs of health coverage for lower- and middle-income Californians” moving forward. The \u003ca href=\"https://sbud.senate.ca.gov/sites/sbud.senate.ca.gov/files/Protect%20Our%20Progress%20Senate%20Budget%20Plan.pdf\">Senate budget proposal rejects Newsom’s plan (PDF)\u003c/a> to temporarily move $333.4 million in penalty money from an affordability reserve to the general fund, calling it a “rip-off” of Covered California funds.\u003c/p>\n\u003cp>“Our plan protects important advancements that California has made that has moved us towards a more equitable and sustainable economy,” Senate Budget Chair \u003ca href=\"https://calmatters.org/legislator-tracker/nancy-skinner-1954/\">Nancy Skinner\u003c/a> said during a press briefing last week.\u003c/p>\n\u003cp>In 2019, Newsom proposed and the Legislature passed a polarizing tax penalty on Californians without health insurance, known as the individual mandate, with verbal assurances that it would be used to lower health care costs for those who have insurance through Covered California, the state version of the Affordable Care Act marketplace. Though \u003ca href=\"https://californiahealthline.org/news/article/health-insurance-mandate-penalties/\">more than $1 billion has been collected in the past four years\u003c/a>, the money has only been used once to lower costs for enrollees, about $355 million in 2020.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The \u003ca href=\"https://sbud.senate.ca.gov/sites/sbud.senate.ca.gov/files/Protect%20Our%20Progress%20Senate%20Budget%20Plan.pdf\">Senate Democrats’ budget proposal (PDF)\u003c/a>, which relies on corporate tax hikes that \u003ca href=\"https://calmatters.org/newsletters/whatmatters/2023/04/california-taxes-budget/\">Newsom swiftly rejected\u003c/a> to avoid a variety of cuts, \u003ca href=\"https://calmatters.org/commentary/2023/05/democrats-at-odds-budget-deficit/\">sets the stage for an intense period of negotiation\u003c/a> between the Legislature and governor as they hash out a state spending plan in the face of diminishing tax revenue. The Senate’s counter proposal would mandate using the money to eliminate deductibles and copays for roughly 900,000 Covered California enrollees next year. It’s one of several health care funding battles heating up amid a bleak budget year, including a fight to infuse emergency cash into \u003ca href=\"https://calmatters.org/health/2023/04/hospital-closures-california/\">hospitals on the brink of closure\u003c/a>.\u003c/p>\n\u003cp>Newsom is expected to disclose later this month an even more dismal financial picture for the state than the \u003ca href=\"https://calmatters.org/california-budget/2023/01/california-budget-newsom-deficit/\">$22.5 billion deficit he projected in his January budget proposal\u003c/a>.\u003c/p>\n\u003cp>In a statement, Brandon Richards, spokesperson for Newsom, said the governor will “continue to work with the California Legislature to develop the final budget package” in the coming months.\u003c/p>\n\u003cp>This is just one step in a long budget negotiation that will stretch to June. If the Senate’s counterproposal makes it into the state’s final budget come summer, leadership intends to end the diversion of penalty money permanently. Notably, Democratic leaders from the Assembly have not endorsed the Senate’s spending plan nor put forth their own proposal, but John Casey, communications director for Assembly Speaker Anthony Rendon, said both houses are interested in the issue.\u003c/p>\n\u003cp>“We’ll see what the May revision includes and the two houses will advance their priorities as best they can in negotiations afterward,” Casey said.\u003c/p>\n\u003ch2>‘A bitter pill’\u003c/h2>\n\u003cp>In recent committee hearings, Assembly and Senate legislators have lambasted this particular proposal in Newsom’s budget.\u003c/p>\n\u003cp>“I’m trying to make sure that those dollars stay in this area to address affordability, and I’m not hearing from the administration that same commitment,” said Assemblymember \u003ca href=\"https://calmatters.org/legislator-tracker/joaquin-arambula-1977/\">Joaquin Arambula\u003c/a>, a Fresno Democrat and chairperson of the Assembly budget subcommittee on health.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Sen. \u003ca href=\"https://calmatters.org/legislator-tracker/caroline-menjivar-1989/\">Caroline Menjivar\u003c/a>, a newly elected Democrat from Van Nuys and chairperson of the Senate budget subcommittee on health, criticized the governor’s plan for saving money “on the backs of our low-income communities.”\u003c/p>\n\u003cp>On his first day in office, Newsom proposed reinstating a tax on people without health insurance to fund increased subsidies for people who have Covered California insurance. A previous \u003ca href=\"https://www.cnbc.com/2018/01/30/trump-touts-repeal-of-obamacare-individual-mandate.html\">federal version of the tax had been repealed by the Trump administration\u003c/a> the year prior, which contributed to a \u003ca href=\"https://hbex.coveredca.com/financial-reports/PDFs/2019/fy-2019-20-annual-report-final.pdf\">24% drop in enrollment in Covered California plans (PDF)\u003c/a>.\u003c/p>\n\u003cp>New taxes always trigger a \u003ca href=\"https://www.capradio.org/articles/2019/02/21/californias-individual-mandate-a-fix-for-a-broken-system-or-a-penalty-on-the-poor/\">legislative skirmish\u003c/a>, but this one gave even Democratic lawmakers and powerful advocacy groups pause: Theoretically, the tax would encourage more people to get health insurance, lowering the overall cost for everyone in the marketplace, but the penalty would come out of the pockets of the state’s poorest residents — those who forego insurance because it’s too expensive.\u003c/p>\n\u003cp>The Legislature ultimately approved the tax in 2019 with the understanding that the projected $1.4 billion in revenue over three years would be used to lower insurance costs.\u003c/p>\n\u003cp>The majority of that money, however, has stayed in the state’s general fund. Newsom has previously argued that the federal government’s more generous COVID-19 subsidies, which extend through 2025, render additional state spending unnecessary, especially at a time when California faces a growing deficit.\u003c/p>\n\u003cp>But legislators in both the Senate and the Assembly say that’s not what they voted for.\u003c/p>\n\u003cp>“The individual mandate was not intended to create funds for other government programs outside of health care from my perspective,” Assemblymember \u003ca href=\"https://calmatters.org/legislator-tracker/jim-wood-1960/\">Jim Wood\u003c/a> said during a recent budget subcommittee meeting. “I don’t think I would have supported it if that was the way I thought it would end up.”\u003c/p>\n\u003cp>Wood, a Democrat from Santa Rosa who leads the Assembly Health Committee, called the diversion to the general fund “a bitter pill to swallow.”\u003c/p>\n\u003cp>During the hearing, Department of Finance analyst Matt Aguilera argued using the money to alleviate the deficit would not impact current services under Covered California.\u003c/p>\n\u003cp>“Everybody is concerned about affordability. There’s agreement on that. Just due to the economic situation this may not be a good time to start up new programs,” Aguilera said.\u003c/p>\n\u003cp>But advocates argue using the revenue from the individual mandate penalty wouldn’t be new spending. It would be fulfilling an existing commitment.\u003c/p>\n\u003ch2>Costs keep rising\u003c/h2>\n\u003cp>Last year, in tandem with \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=202120220SB944\">a measure to ensure the penalty money no longer got diverted\u003c/a>, the Covered California board approved a plan to eliminate deductibles for the state’s \u003ca href=\"https://www.healthforcalifornia.com/covered-california/plans?gclid=CjwKCAjwxr2iBhBJEiwAdXECw-W0XW5KoSAgoaM1h7Q2V7Khe0nQuGMOs73i3BBK8Mnu7fhFl6vjzRoC-wIQAvD_BwE\">mid-tier coverage option\u003c/a>, which is widely considered the most cost-effective insurance option. When \u003ca href=\"https://www.gov.ca.gov/wp-content/uploads/2022/09/SB-944-veto-message.pdf?emrc=af81f2\">Newsom vetoed the policy bill (PDF)\u003c/a>, citing a “downturn in revenues,” the plan was abandoned.\u003c/p>\n\u003cp>“Last year this was a priority for everybody: the health plans, business groups, both the Assembly and Senate prioritized it in their budgets, health advocates, Covered California itself. Everybody lined up to support this,” said Rachel Linn Gish, communications director for Health Access California, a consumer advocacy lobbying group. “The only person we didn’t have was the governor.”\u003c/p>\n\u003cp>Instead, \u003ca href=\"https://www.coveredca.com/pdfs/2022-Health-Benefits-table.pdf\">deductibles jumped from $3,700 for an individual and $7,400 for a family with a mid-tier plan (PDF)\u003c/a> to \u003ca href=\"https://www.coveredca.com/pdfs/Health-Benefits-table.pdf\">$4,750 and $9,500, respectively (PDF)\u003c/a>. Health Access is sponsoring \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=202320240AB1208\">another measure\u003c/a> this year to ensure money appropriated for Covered California affordability measures is used for that purpose.\u003c/p>\n\u003cp>\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe loading=\"lazy\" src=\"https://flo.uri.sh/visualisation/12755159/embed?auto=1\" width=\"800\" height=\"550\" scrolling=\"yes\" class=\"iframe-class\" frameborder=\"0\">\u003c/iframe>\u003c/p>\n\u003cp>“One of the most direct and impactful ways we can make sure consumers get health care access right now is by lowering the cost of care,” Linn Gish said. “The 2025 (federal subsidy) sunset was the governor’s main sticking point … but to us, it’s 2023. Why can’t we help people now?”\u003c/p>\n\u003cp>Senate Democrats also rejected delays and cuts to investments in the state’s health care workforce, including a $49.8 million cut to training programs for public health workers. Michelle Gibbons, executive director of the County Health Executives Association of California, said the money was sorely needed after decades of public health budget cuts left the state scrambling to respond to the COVID-19 pandemic.\u003c/p>\n\u003cp>“We can’t even begin to grow the pipeline of microbiologists, lab directors, epidemiologists — very skilled positions — without these programs and investments,” Gibbons said.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>It’s unclear, however, how feasible the Senate Democrats’ proposal is with the state facing an economic downturn. Most of the cuts avoided are funded through a $6 billion proposed corporate tax hike and $5 billion suspension of a major tax credit, which \u003ca href=\"https://calmatters.org/newsletters/whatmatters/2023/04/california-taxes-budget/\">Newsom rejected within hours of the proposal’s release\u003c/a>.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "New California Law Targets Inequity in Cancer Care. Some Say It Doesn't Go Far Enough",
"title": "New California Law Targets Inequity in Cancer Care. Some Say It Doesn't Go Far Enough",
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"content": "\u003cp>Cancer is the second-leading cause of death in California, behind only heart disease. This year alone, the state will tally an estimated \u003ca href=\"https://cancerstatisticscenter.cancer.org/#!/state/California\">189,000 new cancer cases\u003c/a> and close to 61,000 deaths.\u003c/p>\n\u003cp>Yet while patients often need specialists, treatments and the chance to participate in clinical trials, that access is not equitable throughout the state. It typically depends on where patients live, and sometimes on their health insurance.\u003c/p>\n\u003cp>Cancer patients with lower incomes — and especially those in rural places — \u003ca href=\"https://www.cancer.gov/news-events/cancer-currents-blog/2020/persistent-poverty-increased-cancer-death-risk#:~:text=A%20new%20study%20by%20NCI,than%20people%20in%20other%20counties.\">tend to fare worse\u003c/a>. \u003ca href=\"https://escholarship.org/content/qt8xc078vj/qt8xc078vj_noSplash_451b26b4f066a1cfb27ba71f52096a73.pdf?t=nxk0lm\">Studies have shown (PDF)\u003c/a> that patients with Medi-Cal, the health insurance program for residents with lower incomes, are less likely to get the recommended treatment and have lower cancer survival rates compared to people with private insurance.\u003c/p>\n\u003cp>This disparity is at the crux of a California bill recently signed into law by Gov. Gavin Newsom that supporters say will make it at least a little easier for Medi-Cal patients to access cancer subspecialists, treatments and clinical trials.[pullquote size=\"medium\" align=\"right\" citation=\"Linda Nguy, policy advocate, Western Center on Law and Poverty\"]'Actually requiring plans [to contract with cancer centers] — that would have brought some meat to the table. From our understanding, plans already make efforts to contract with as many providers as possible, but it comes down to a reimbursement issue.'[/pullquote]\u003ca href=\"https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=202120220SB987\">The new law\u003c/a>, which goes into effect in January, requires Medi-Cal insurance plans to “make a good faith effort” to contract with \u003ca href=\"https://www.cancer.gov/research/infrastructure/cancer-centers\">cancer centers recognized by the National Cancer Institute\u003c/a> — which often have access to the latest treatments — or other qualifying cancer centers.\u003c/p>\n\u003cp>Authored by Democratic \u003ca href=\"https://calmatters.org/legislator-tracker/anthony-portantino-1961/\">Sen. Anthony Portantino\u003c/a> of Glendale, it was originally drafted to mandate that Medi-Cal plans add at least one of these cancer centers to their provider networks, but negotiations resulted in a scaled-back version, only requiring health plans to \u003cem>try\u003c/em> to add a cancer center.\u003c/p>\n\u003cp>The law also requires Medi-Cal plans to notify enrollees with complex cancers about their right to request a referral to any of these centers, even if it’s out of their plan’s network. Whether a patient can be treated at one of these centers, however, depends on whether the plan and the out-of-network provider can hash out a payment deal. This referral notification, supporters say, is critical: Patients can’t ask for something they don’t know is an option.\u003c/p>\n\u003cp>Supporters say that even if limited, this law will be an important step toward helping cancer patients with lower incomes get specialized care.\u003c/p>\n\u003cp>“I think making incremental change has the ability to save lives and that’s what we’re trying to do here,” Portantino said.\u003c/p>\n\u003cp>Too often patients from underserved communities arrive at these specialized cancer centers very late after their diagnoses, said Dr. Joseph Alvarnas, hematologist-oncologist and vice president of government affairs at \u003ca href=\"https://www.cityofhope.org/\">City of Hope\u003c/a>, one of eight California cancer centers with a National Cancer Institute designation, and a sponsor of the law.\u003c/p>\n\u003cp>“The conversation begins with, ‘If I could only have gotten here sooner,’ or ‘My family and I fought tooth-and-nail to get here,’” he said.\u003c/p>\n\u003cp>Alvarnas said that, historically, City of Hope used to see more Medi-Cal patients, but that changed as the state has largely moved its Medi-Cal program from a fee-for-service model (in which patients could see any provider who accepted Medi-Cal and the state paid providers for each service rendered) to managed care (considered a more cost-effective model, in which the state pays health insurance companies a fixed amount per enrollee).\u003c/p>\n\u003cp>“In managed care, part of the way that model works is it includes narrower clinician networks and more limited hospital choices,” Alvarnas said. “If you have high blood pressure or you’ve got a condition that can be cared for by many types of doctors, that’s an OK model.\u003c/p>\n\u003cp>“But when it comes to cancer care, your network of clinicians may not have an expert in leukemia or relapsed myeloma.”\u003c/p>\n\u003cp>Hospitals sometimes must send some of their sickest patients to cancer centers like City of Hope — as was the case for Patrick Nandy of Whittier. In 2008, during his senior year of college, he was diagnosed with acute lymphoblastic leukemia, a cancer of the blood and bone marrow that can progress very quickly. Nandy said that when oncologists at St. Jude Medical Center could no longer treat him, he was transferred to City of Hope, where he participated in a chemotherapy clinical trial and a cord blood stem cell transplant.\u003c/p>\n\u003cp>“I think about how lucky I am,” Nandy said. “Doctors said two more weeks and I probably would have been gone.”\u003c/p>\n\u003cp>These are the types of therapies that should be available to all patients with complex or aggressive cancers, but that’s not always the case, Alvarnas said.\u003c/p>\n\u003cp>A \u003ca href=\"https://escholarship.org/content/qt8xc078vj/qt8xc078vj_noSplash_451b26b4f066a1cfb27ba71f52096a73.pdf?t=nxk0lm\">2015 analysis by the University of California, Davis (PDF)\u003c/a> found worse outcomes for cancer patients with Medi-Cal compared to people with other types of insurance. Among some of the findings: Thirty-nine percent of breast cancer patients on Medi-Cal were diagnosed at an early stage compared to 61% of those who were privately insured.\u003c/p>\n\u003cp>The study also found Medi-Cal patients diagnosed with early stage lung cancer had a 48% five-year survival rate, lower than the 65% five-year survival rate for those with private insurance. Medi-Cal patients also were less likely to receive the necessary therapies or treatments for several cancer types.\u003c/p>\n\u003cp>The law will apply to people with rare or complex cancers, including advanced stage brain cancer, lung cancer, colorectal cancer, leukemia and lymphoma, among others, Alvarnas said. The sought- after treatment and research centers include City of Hope, University of California comprehensive cancer centers, the Stanford Cancer Institute, as well as a number of Kaiser Permanente sites and the Cedars-Sinai Cancer Institute.\u003c/p>\n\u003cp>While the law as passed had no registered opposition, it was watered down during negotiations involving providers, health plans and the California Department of Health Care Services, which oversees the Medi-Cal program.\u003c/p>\n\u003cp>\u003ca href=\"https://calmatters.org/wp-content/uploads/2022/06/SB-987-Portantino-Author-OPPOSE-4.12.22.pdf\">Health insurance plans initially opposed Portantino’s bill (PDF)\u003c/a> because requiring plans to contract with centers, they warned, comes with new administrative hurdles that could disrupt or delay patient care.[pullquote size=\"medium\" align=\"right\" citation=\"Dr. Joseph Alvarnas, vice president of government affairs, City of Hope\"]'The state has worked very hard over the last decade to improve health care coverage. The issue, though, is there's a gulf between coverage and real access, because there is also a focus by the state to make sure that health care costs are somewhat controlled.'[/pullquote]\u003c/p>\n\u003cp>Linda Nguy, an advocate with the Western Center on Law and Poverty, said her organization withdrew its support after the bill was narrowed. “Actually requiring plans [to contract with cancer centers] — that would have brought some meat to the table,” Nguy said. “From our understanding, plans already make efforts to contract with as many providers as possible, but it comes down to a reimbursement issue.”\u003c/p>\n\u003cp>Medi-Cal, which covers about a third of Californians, pays providers \u003ca href=\"https://www.urban.org/sites/default/files/publication/88836/2001180-medicaid-physician-fees-after-the-aca-primary-care-fee-bump_0.pdf\">a lower rate than other insurance types (PDF)\u003c/a>. While lower reimbursement rates make the program \u003ca href=\"https://www.cbpp.org/research/health/frequently-asked-questions-about-medicaid\">more cost-efficient\u003c/a>, \u003ca href=\"https://www.healthaffairs.org/do/10.1377/forefront.20190401.678690/full/\">low payments can deter providers\u003c/a> from participating in Medi-Cal.\u003c/p>\n\u003cp>The debate over cancer care equity shows the complexities of achieving true access even in a state that has expanded insurance coverage to more people. California is scheduled to become the first state in the country to offer Medi-Cal coverage to all income-eligible people regardless of immigration status. Last week, Gov. Gavin Newsom’s office announced that \u003ca href=\"https://www.gov.ca.gov/2022/10/19/medi-cal-expansion-provided-286000-undocumented-californians-with-comprehensive-health-care/#:~:text=SACRAMENTO%20%E2%80%93%20Today%2C%20Governor%20Gavin%20Newsom,years%20of%20age%20and%20older%2C\">286,000 undocumented people age 50 and older started to receive comprehensive coverage in May\u003c/a>. In 2024, California will open the Medi-Cal program to approximately 700,000 more people ages 26 to 49.\u003c/p>\n\u003cp>“The state has worked very hard over the last decade to improve health care coverage,” Alvarnas said. “The issue, though, is there’s a gulf between coverage and real access, because there is also a focus by the state to make sure that health care costs are somewhat controlled.”\u003c/p>\n\u003cp>While the bill fell short of what supporters initially aimed for, the work to make cancer care more easily accessible will continue, said Autumn Ogden-Smith, director of state legislation for the American Cancer Society Cancer Action Network, another sponsor of the bill. For instance, how to more easily get a patient into one of these cancer centers if they don’t live nearby is a priority, she said.\u003c/p>\n\u003cp>“If you pull up a map, you’ll see these centers tend to cover certain areas — San Diego, Los Angeles, San Francisco, Davis-Sacramento,” Ogden-Smith said. “We’re going to have to focus on how we get the people in Northern California and in the middle of the state” to cancer centers, she said.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"nprByline": "\u003ca href=\"https://calmatters.org/author/anaibarra/\">Ana B. Ibarra\u003c/a>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Cancer is the second-leading cause of death in California, behind only heart disease. This year alone, the state will tally an estimated \u003ca href=\"https://cancerstatisticscenter.cancer.org/#!/state/California\">189,000 new cancer cases\u003c/a> and close to 61,000 deaths.\u003c/p>\n\u003cp>Yet while patients often need specialists, treatments and the chance to participate in clinical trials, that access is not equitable throughout the state. It typically depends on where patients live, and sometimes on their health insurance.\u003c/p>\n\u003cp>Cancer patients with lower incomes — and especially those in rural places — \u003ca href=\"https://www.cancer.gov/news-events/cancer-currents-blog/2020/persistent-poverty-increased-cancer-death-risk#:~:text=A%20new%20study%20by%20NCI,than%20people%20in%20other%20counties.\">tend to fare worse\u003c/a>. \u003ca href=\"https://escholarship.org/content/qt8xc078vj/qt8xc078vj_noSplash_451b26b4f066a1cfb27ba71f52096a73.pdf?t=nxk0lm\">Studies have shown (PDF)\u003c/a> that patients with Medi-Cal, the health insurance program for residents with lower incomes, are less likely to get the recommended treatment and have lower cancer survival rates compared to people with private insurance.\u003c/p>\n\u003cp>This disparity is at the crux of a California bill recently signed into law by Gov. Gavin Newsom that supporters say will make it at least a little easier for Medi-Cal patients to access cancer subspecialists, treatments and clinical trials.\u003c/p>\u003c/div>",
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"content": "'Actually requiring plans [to contract with cancer centers] — that would have brought some meat to the table. From our understanding, plans already make efforts to contract with as many providers as possible, but it comes down to a reimbursement issue.'",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003ca href=\"https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=202120220SB987\">The new law\u003c/a>, which goes into effect in January, requires Medi-Cal insurance plans to “make a good faith effort” to contract with \u003ca href=\"https://www.cancer.gov/research/infrastructure/cancer-centers\">cancer centers recognized by the National Cancer Institute\u003c/a> — which often have access to the latest treatments — or other qualifying cancer centers.\u003c/p>\n\u003cp>Authored by Democratic \u003ca href=\"https://calmatters.org/legislator-tracker/anthony-portantino-1961/\">Sen. Anthony Portantino\u003c/a> of Glendale, it was originally drafted to mandate that Medi-Cal plans add at least one of these cancer centers to their provider networks, but negotiations resulted in a scaled-back version, only requiring health plans to \u003cem>try\u003c/em> to add a cancer center.\u003c/p>\n\u003cp>The law also requires Medi-Cal plans to notify enrollees with complex cancers about their right to request a referral to any of these centers, even if it’s out of their plan’s network. Whether a patient can be treated at one of these centers, however, depends on whether the plan and the out-of-network provider can hash out a payment deal. This referral notification, supporters say, is critical: Patients can’t ask for something they don’t know is an option.\u003c/p>\n\u003cp>Supporters say that even if limited, this law will be an important step toward helping cancer patients with lower incomes get specialized care.\u003c/p>\n\u003cp>“I think making incremental change has the ability to save lives and that’s what we’re trying to do here,” Portantino said.\u003c/p>\n\u003cp>Too often patients from underserved communities arrive at these specialized cancer centers very late after their diagnoses, said Dr. Joseph Alvarnas, hematologist-oncologist and vice president of government affairs at \u003ca href=\"https://www.cityofhope.org/\">City of Hope\u003c/a>, one of eight California cancer centers with a National Cancer Institute designation, and a sponsor of the law.\u003c/p>\n\u003cp>“The conversation begins with, ‘If I could only have gotten here sooner,’ or ‘My family and I fought tooth-and-nail to get here,’” he said.\u003c/p>\n\u003cp>Alvarnas said that, historically, City of Hope used to see more Medi-Cal patients, but that changed as the state has largely moved its Medi-Cal program from a fee-for-service model (in which patients could see any provider who accepted Medi-Cal and the state paid providers for each service rendered) to managed care (considered a more cost-effective model, in which the state pays health insurance companies a fixed amount per enrollee).\u003c/p>\n\u003cp>“In managed care, part of the way that model works is it includes narrower clinician networks and more limited hospital choices,” Alvarnas said. “If you have high blood pressure or you’ve got a condition that can be cared for by many types of doctors, that’s an OK model.\u003c/p>\n\u003cp>“But when it comes to cancer care, your network of clinicians may not have an expert in leukemia or relapsed myeloma.”\u003c/p>\n\u003cp>Hospitals sometimes must send some of their sickest patients to cancer centers like City of Hope — as was the case for Patrick Nandy of Whittier. In 2008, during his senior year of college, he was diagnosed with acute lymphoblastic leukemia, a cancer of the blood and bone marrow that can progress very quickly. Nandy said that when oncologists at St. Jude Medical Center could no longer treat him, he was transferred to City of Hope, where he participated in a chemotherapy clinical trial and a cord blood stem cell transplant.\u003c/p>\n\u003cp>“I think about how lucky I am,” Nandy said. “Doctors said two more weeks and I probably would have been gone.”\u003c/p>\n\u003cp>These are the types of therapies that should be available to all patients with complex or aggressive cancers, but that’s not always the case, Alvarnas said.\u003c/p>\n\u003cp>A \u003ca href=\"https://escholarship.org/content/qt8xc078vj/qt8xc078vj_noSplash_451b26b4f066a1cfb27ba71f52096a73.pdf?t=nxk0lm\">2015 analysis by the University of California, Davis (PDF)\u003c/a> found worse outcomes for cancer patients with Medi-Cal compared to people with other types of insurance. Among some of the findings: Thirty-nine percent of breast cancer patients on Medi-Cal were diagnosed at an early stage compared to 61% of those who were privately insured.\u003c/p>\n\u003cp>The study also found Medi-Cal patients diagnosed with early stage lung cancer had a 48% five-year survival rate, lower than the 65% five-year survival rate for those with private insurance. Medi-Cal patients also were less likely to receive the necessary therapies or treatments for several cancer types.\u003c/p>\n\u003cp>The law will apply to people with rare or complex cancers, including advanced stage brain cancer, lung cancer, colorectal cancer, leukemia and lymphoma, among others, Alvarnas said. The sought- after treatment and research centers include City of Hope, University of California comprehensive cancer centers, the Stanford Cancer Institute, as well as a number of Kaiser Permanente sites and the Cedars-Sinai Cancer Institute.\u003c/p>\n\u003cp>While the law as passed had no registered opposition, it was watered down during negotiations involving providers, health plans and the California Department of Health Care Services, which oversees the Medi-Cal program.\u003c/p>\n\u003cp>\u003ca href=\"https://calmatters.org/wp-content/uploads/2022/06/SB-987-Portantino-Author-OPPOSE-4.12.22.pdf\">Health insurance plans initially opposed Portantino’s bill (PDF)\u003c/a> because requiring plans to contract with centers, they warned, comes with new administrative hurdles that could disrupt or delay patient care.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Linda Nguy, an advocate with the Western Center on Law and Poverty, said her organization withdrew its support after the bill was narrowed. “Actually requiring plans [to contract with cancer centers] — that would have brought some meat to the table,” Nguy said. “From our understanding, plans already make efforts to contract with as many providers as possible, but it comes down to a reimbursement issue.”\u003c/p>\n\u003cp>Medi-Cal, which covers about a third of Californians, pays providers \u003ca href=\"https://www.urban.org/sites/default/files/publication/88836/2001180-medicaid-physician-fees-after-the-aca-primary-care-fee-bump_0.pdf\">a lower rate than other insurance types (PDF)\u003c/a>. While lower reimbursement rates make the program \u003ca href=\"https://www.cbpp.org/research/health/frequently-asked-questions-about-medicaid\">more cost-efficient\u003c/a>, \u003ca href=\"https://www.healthaffairs.org/do/10.1377/forefront.20190401.678690/full/\">low payments can deter providers\u003c/a> from participating in Medi-Cal.\u003c/p>\n\u003cp>The debate over cancer care equity shows the complexities of achieving true access even in a state that has expanded insurance coverage to more people. California is scheduled to become the first state in the country to offer Medi-Cal coverage to all income-eligible people regardless of immigration status. Last week, Gov. Gavin Newsom’s office announced that \u003ca href=\"https://www.gov.ca.gov/2022/10/19/medi-cal-expansion-provided-286000-undocumented-californians-with-comprehensive-health-care/#:~:text=SACRAMENTO%20%E2%80%93%20Today%2C%20Governor%20Gavin%20Newsom,years%20of%20age%20and%20older%2C\">286,000 undocumented people age 50 and older started to receive comprehensive coverage in May\u003c/a>. In 2024, California will open the Medi-Cal program to approximately 700,000 more people ages 26 to 49.\u003c/p>\n\u003cp>“The state has worked very hard over the last decade to improve health care coverage,” Alvarnas said. “The issue, though, is there’s a gulf between coverage and real access, because there is also a focus by the state to make sure that health care costs are somewhat controlled.”\u003c/p>\n\u003cp>While the bill fell short of what supporters initially aimed for, the work to make cancer care more easily accessible will continue, said Autumn Ogden-Smith, director of state legislation for the American Cancer Society Cancer Action Network, another sponsor of the bill. For instance, how to more easily get a patient into one of these cancer centers if they don’t live nearby is a priority, she said.\u003c/p>\n\u003cp>“If you pull up a map, you’ll see these centers tend to cover certain areas — San Diego, Los Angeles, San Francisco, Davis-Sacramento,” Ogden-Smith said. “We’re going to have to focus on how we get the people in Northern California and in the middle of the state” to cancer centers, she said.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"slug": "medi-cal-shake-up-might-create-more-problems-than-solutions-for-low-income-californians",
"title": "Medi-Cal Shake-Up Might Create More Problems Than Solutions for Lower-Income Californians",
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"headTitle": "Medi-Cal Shake-Up Might Create More Problems Than Solutions for Lower-Income Californians | KQED",
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"content": "\u003cp>Almost 2 million of California’s lowest-income and most medically fragile residents may have to switch health insurers as a result of a new strategy by the state to improve care in its Medicaid program, called Medi-Cal.\u003c/p>\n\u003cp>A first-ever statewide contracting competition to participate in Medi-Cal required commercial managed-care plans to rebid for their contracts and compete against others hoping to take those contracts away. The contracts will be revamped to require insurers to offer new benefits and meet stiffer benchmarks for care.\u003c/p>\n\u003cp>The long-planned reshuffle of insurers is likely to come with short-term pain. Four of the managed-care insurers, including Health Net and Blue Shield of California, stand to \u003ca href=\"https://www.dhcs.ca.gov/CalAIM/Documents/MCP-County-Enrollment-Table.pdf\">lose Medi-Cal contracts\u003c/a> in a little over a year, according to the \u003ca href=\"https://www.dhcs.ca.gov/formsandpubs/publications/oc/Documents/2022/22-10-MCP-Selections-8-25-22.pdf\">preliminary results of the bidding\u003c/a>, announced in late August. If the results stand, some enrollees in rural Alpine and El Dorado counties, as well as in populous Los Angeles, San Diego, Sacramento and Kern counties, will have to change health plans — and possibly doctors.[aside label='Related Coverage' tag='medicaid']“I’m still shocked and I’m still reeling from it,” said John Sturm, \u003ca href=\"https://www.dhcs.ca.gov/CalAIM/Documents/MCP-County-Enrollment-Table.pdf\">one of about 325,000 members of Community Health Group\u003c/a>, the largest Medi-Cal plan in San Diego County, which could lose its contract. “Which doctors can I keep? How long is it going to take me to switch plans? Are there contingency plans when, inevitably, folks slip through the cracks?”\u003c/p>\n\u003cp>Sturm, 54, who has three mental health conditions, largely because of childhood sexual abuse, said finding a psychologist and psychiatrist he could trust took a lot of time and effort. He pointed to \u003ca href=\"https://californiahealthline.org/news/article/california-medicaid-patients-struggle-to-fill-prescriptions-medi-cal-rx/\">the disruption caused by the rollout of Medi-Cal’s new prescription drug program\u003c/a> this year, despite assurances it would go smoothly.\u003c/p>\n\u003cp>“I have concerns, and I know other people in the community have concerns about what we’re being told versus what the reality is going to be,” Sturm said.\u003c/p>\n\u003cp>Arguably, the biggest loser in the bidding is Health Net, the largest commercial insurer in Medi-Cal, which stands to lose half its enrollees — including more than 1 million in Los Angeles County alone. St. Louis-based Centene Corp., which \u003ca href=\"https://www.latimes.com/california/story/2022-04-07/california-investigating-corporation-took-over-medicaid-drug-program\">California is investigating\u003c/a> over allegations it overcharged the state for prescription drugs, \u003ca href=\"https://www.prnewswire.com/news-releases/centene-completes-acquisition-of-health-net-300241037.html\">bought Health Net\u003c/a> in 2016, in part for its Medicaid business, of which LA is the crown jewel.\u003c/p>\n\u003cp>But the state’s health plan selections are not set in stone. The losing insurers are fiercely contesting the results in formal appeals that read like declarations of war on their competitors and on the state. Some of the losers essentially call their winning rivals liars.\u003c/p>\n\u003cp>The stakes are high, with contracts in play worth billions of dollars annually. Insurers that lose their appeals with the state Department of Health Care Services, which runs Medi-Cal, are likely to take their complaints to court. That could delay final decisions by months or years, causing a headache for the department, which wants coverage under the new contracts to start Jan. 1, 2024.\u003c/p>\n\u003cp>State officials hope to spend the rest of this year and all of 2023 ensuring that the chosen health plans are up to the task, which includes having enough participating providers to minimize disruptions in care.\u003c/p>\n\u003cp>“Member access and continuity are really our top priorities as part of this transition, and we have dedicated teams that will be working with the health plans on the transition planning and the continuity planning,” Michelle Baass, director of the department, told KHN.[pullquote size=\"medium\" align=\"right\" citation=\"John Sturm, Medi-Cal recipient\"]‘I have concerns, and I know other people in the community have concerns about what we’re being told versus what the reality is going to be.’[/pullquote]Baass also noted that enrollees have continuity-of-care rights. “For example, if a member is currently under the care of a doctor during the prior 12 months, the member has the right to continue seeing that doctor for up to 12 months, if certain conditions are met,” she said.\u003c/p>\n\u003cp>The competitive bidding process is an effort by the department to address persistent complaints that \u003ca href=\"https://californiahealthline.org/news/article/californias-reboot-of-troubled-medi-cal-puts-pressure-on-health-plans/\">it has not effectively monitored subpar health plans\u003c/a>.\u003c/p>\n\u003cp>Eight commercial insurers bid for Medi-Cal business in 21 counties. They were required to submit voluminous documents detailing every aspect of their operations, including past performance; the scope of their provider networks; and their capacity to meet the terms of the new, stricter contracts.\u003c/p>\n\u003cp>The new contracts contain numerous provisions intended to bolster quality, health care equity and transparency — and to boost accountability of the subcontractors to whom \u003ca href=\"https://californiahealthline.org/news/article/layers-of-subcontracted-services-confuse-and-frustrate-medi-cal-patients/\">health plans often outsource patient care\u003c/a>. For example, the plans and their subcontractors will be required to reach or exceed \u003ca href=\"https://www.dhcs.ca.gov/Documents/MCP-RFP-Issue-Brief.pdf\">the 50th percentile\u003c/a> among Medicaid plans nationally on a host of pediatric and maternal care measures — or face financial penalties.\u003c/p>\n\u003cp>They will also be on the hook for providing nonmedical social services that address socioeconomic factors, such as homelessness and food insecurity, in an ambitious $8.7 billion, \u003ca href=\"https://khn.org/news/article/california-medicaid-makeover-newsom-california-medi-cal-homeless-public-funds/\">five-year Medi-Cal initiative known as CalAIM\u003c/a>, that is already underway.\u003c/p>\n\u003cp>Local, publicly governed Medi-Cal plans, which cover about 70% of the \u003ca href=\"https://www.dhcs.ca.gov/dataandstats/statistics/Documents/FastFacts-March2022.pdf\">12.4 million Medi-Cal members who are in managed care\u003c/a>, did not participate in the bidding, though their performance has not always been top-notch. Kaiser Permanente, which this year negotiated a controversial deal with the state for an \u003ca href=\"https://californiahealthline.org/news/article/california-medicaid-contract-kaiser-permanente-key-details-missing/\">exclusive Medi-Cal contract\u003c/a> in 32 counties, was also exempt from the bidding. (KHN is not affiliated with Kaiser Permanente.)\u003c/p>\n\u003cp>But all Medi-Cal health insurers, including KP and the local plans, will have to commit to the same goals and requirements.\u003c/p>\n\u003cp>In addition to Health Net, both Blue Shield of California and Community Health Group — which have contracts with Medi-Cal only in San Diego County — are also big losers, as is Aetna, which lost bids in 10 counties.\u003c/p>\n\u003cp>Blue Shield, which lost in all 13 counties where it submitted bids, filed a fiercely worded appeal that accuses its rivals Anthem Blue Cross, Molina and Health Net of failing to disclose hundreds of millions of dollars in penalties against them. It accused those three plans of poor performance “and even mendacity” and said they filled their bids with “puffery,” which the state “bought, hook, line and sinker,” without “an iota of independent analysis.”\u003c/p>\n\u003cfigure id=\"attachment_11926773\" class=\"wp-caption alignnone\" style=\"max-width: 724px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11926773\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2022/09/GettyImages-1279766844.jpg\" alt=\"A hand in the foreground holds a card as someone reaches out to hold it from across a table.\" width=\"724\" height=\"483\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2022/09/GettyImages-1279766844.jpg 724w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/09/GettyImages-1279766844-160x107.jpg 160w\" sizes=\"(max-width: 724px) 100vw, 724px\">\u003cfigcaption class=\"wp-caption-text\">The competitive bidding process is an effort by the state Department of Health Care Services to address persistent complaints that it has not effectively monitored subpar health plans. \u003ccite>(Willie B. Thomas/Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Health Net’s appeal slammed Molina, which beat it out in LA, Sacramento, Riverside and San Bernardino counties. Molina’s bid, Health Net said, “contains false, inaccurate and misleading information.” The whole bidding process, it said, was “highly flawed,” resulting in “erroneous contract awards that jeopardize the stability of Medi-Cal.”\u003c/p>\n\u003cp>In particular, Health Net said, the Department of Health Care Services “improperly reopened the procurement” after the deadline, which allowed Molina to make “comprehensive changes” that raised its score.\u003c/p>\n\u003cp>The protesting health plans are requesting that they be awarded contracts or that the bidding process start over from scratch.\u003c/p>\n\u003cp>Joseph Garcia, chief operating officer for Community Health Group, said, “It would be easiest for all concerned if they just added us. They don’t have to remove anybody.”\u003c/p>\n\u003cp>Community Health Group has garnered an outpouring of support from hospital executives, physician groups, community clinics and the heads of multiple publicly governed Medi-Cal plans, \u003ca href=\"https://californiahealthline.org/wp-content/uploads/sites/3/2022/09/Medi-Cal-Reprocurement-Letter-of-Support-for-CHG-1.pdf\">who sent a letter to Baass\u003c/a> saying they were “shocked, concerned, and very disappointed” by the state’s decision. They called Community Health Group “our strongest partner of 40 years,” for whom “equity is not a buzzword or a new priority,” noting that more than 85% of its staff is bilingual and multicultural.\u003c/p>\n\u003cp>Community Health Group noted in its appeal that it had lost by less than a point to Health Net, which won a San Diego contract — “a minuscule difference that in itself resulted from deeply flawed scoring.”\u003c/p>\n\u003cp>Garcia said that if Community Health Group loses its appeal, it will “absolutely” sue in state court. A hearing officer appointed by Baass to consider the appeals has set deadlines to receive written responses and rebuttals by October 7.\u003c/p>\n\u003cp>There is ample precedent for protracted legal battles in bidding for Medicaid contracts. In Louisiana, Centene and Aetna \u003ca href=\"https://www.thecentersquare.com/louisiana/rejected-bidders-for-louisiana-medicaid-contracts-file-protests-alleging-bias/article_2fe6ecec-c44c-11e9-833d-331f84e9c8f0.html\">protested the results of a 2019 rebidding process\u003c/a>, which led the state to nullify its awards and restart the bidding. The \u003ca href=\"https://ldh.la.gov/news/ldh-mco-contracts\">new results\u003c/a> were announced this year, with Centene and Aetna among the winners. In Kentucky, the state court of appeals \u003ca href=\"https://www.courier-journal.com/story/news/local/2022/09/15/kentucky-medicaid-contracts-upheld-by-court-anthem-is-out-as-mco/69494863007/\">issued a ruling\u003c/a> this month in a contested Medicaid procurement that had been held two years earlier.\u003c/p>\n\u003cp>Another factor could delay the new contract: California is juggling several massive Medi-Cal changes at the same time. Among them are the implementation of CalAIM and the \u003ca href=\"https://lao.ca.gov/Publications/Report/4423\">anticipated enrollment of nearly 700,000 unauthorized immigrants age 26-49\u003c/a> by January 2024, on top of nearly a quarter-million unauthorized immigrants age 50 and older who \u003ca href=\"https://californiahealthline.org/news/article/california-medicaid-older-unauthorized-immigrants/\">became eligible this year\u003c/a>. And then there’s the recalculation of enrollees’ eligibility, which will take place whenever the federal COVID-19-related public health emergency ends. That could push \u003ca href=\"https://www.dhcs.ca.gov/Documents/PHE-UOP/Medi-Cal-COVID-19-PHE-Unwinding-Plan.pdf\">2 million to 3 million\u003c/a> Californians out of Medi-Cal.\u003c/p>\n\u003cp>“Just hearing you list all those things gave me a minor panic attack,” said Abigail Coursolle, a senior attorney at the National Health Law Program. “They are making a lot of work for themselves in a short amount of time.”\u003c/p>\n\u003cp>But, Coursolle added, the state has “a very positive vision for improving access and improving the quality of services that people in Medi-Cal receive, and that’s very important.”\u003c/p>\n\u003cp>\u003cem>California Healthline is a service of the California Health Care Foundation produced by Kaiser Health News.\u003c/em>\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Almost 2 million of California’s lowest-income and most medically fragile residents may have to switch health insurers as a result of a new strategy by the state to improve care in its Medicaid program, called Medi-Cal.\u003c/p>\n\u003cp>A first-ever statewide contracting competition to participate in Medi-Cal required commercial managed-care plans to rebid for their contracts and compete against others hoping to take those contracts away. The contracts will be revamped to require insurers to offer new benefits and meet stiffer benchmarks for care.\u003c/p>\n\u003cp>The long-planned reshuffle of insurers is likely to come with short-term pain. Four of the managed-care insurers, including Health Net and Blue Shield of California, stand to \u003ca href=\"https://www.dhcs.ca.gov/CalAIM/Documents/MCP-County-Enrollment-Table.pdf\">lose Medi-Cal contracts\u003c/a> in a little over a year, according to the \u003ca href=\"https://www.dhcs.ca.gov/formsandpubs/publications/oc/Documents/2022/22-10-MCP-Selections-8-25-22.pdf\">preliminary results of the bidding\u003c/a>, announced in late August. If the results stand, some enrollees in rural Alpine and El Dorado counties, as well as in populous Los Angeles, San Diego, Sacramento and Kern counties, will have to change health plans — and possibly doctors.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>“I’m still shocked and I’m still reeling from it,” said John Sturm, \u003ca href=\"https://www.dhcs.ca.gov/CalAIM/Documents/MCP-County-Enrollment-Table.pdf\">one of about 325,000 members of Community Health Group\u003c/a>, the largest Medi-Cal plan in San Diego County, which could lose its contract. “Which doctors can I keep? How long is it going to take me to switch plans? Are there contingency plans when, inevitably, folks slip through the cracks?”\u003c/p>\n\u003cp>Sturm, 54, who has three mental health conditions, largely because of childhood sexual abuse, said finding a psychologist and psychiatrist he could trust took a lot of time and effort. He pointed to \u003ca href=\"https://californiahealthline.org/news/article/california-medicaid-patients-struggle-to-fill-prescriptions-medi-cal-rx/\">the disruption caused by the rollout of Medi-Cal’s new prescription drug program\u003c/a> this year, despite assurances it would go smoothly.\u003c/p>\n\u003cp>“I have concerns, and I know other people in the community have concerns about what we’re being told versus what the reality is going to be,” Sturm said.\u003c/p>\n\u003cp>Arguably, the biggest loser in the bidding is Health Net, the largest commercial insurer in Medi-Cal, which stands to lose half its enrollees — including more than 1 million in Los Angeles County alone. St. Louis-based Centene Corp., which \u003ca href=\"https://www.latimes.com/california/story/2022-04-07/california-investigating-corporation-took-over-medicaid-drug-program\">California is investigating\u003c/a> over allegations it overcharged the state for prescription drugs, \u003ca href=\"https://www.prnewswire.com/news-releases/centene-completes-acquisition-of-health-net-300241037.html\">bought Health Net\u003c/a> in 2016, in part for its Medicaid business, of which LA is the crown jewel.\u003c/p>\n\u003cp>But the state’s health plan selections are not set in stone. The losing insurers are fiercely contesting the results in formal appeals that read like declarations of war on their competitors and on the state. Some of the losers essentially call their winning rivals liars.\u003c/p>\n\u003cp>The stakes are high, with contracts in play worth billions of dollars annually. Insurers that lose their appeals with the state Department of Health Care Services, which runs Medi-Cal, are likely to take their complaints to court. That could delay final decisions by months or years, causing a headache for the department, which wants coverage under the new contracts to start Jan. 1, 2024.\u003c/p>\n\u003cp>State officials hope to spend the rest of this year and all of 2023 ensuring that the chosen health plans are up to the task, which includes having enough participating providers to minimize disruptions in care.\u003c/p>\n\u003cp>“Member access and continuity are really our top priorities as part of this transition, and we have dedicated teams that will be working with the health plans on the transition planning and the continuity planning,” Michelle Baass, director of the department, told KHN.\u003c/p>\u003c/div>",
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"content": "‘I have concerns, and I know other people in the community have concerns about what we’re being told versus what the reality is going to be.’",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Baass also noted that enrollees have continuity-of-care rights. “For example, if a member is currently under the care of a doctor during the prior 12 months, the member has the right to continue seeing that doctor for up to 12 months, if certain conditions are met,” she said.\u003c/p>\n\u003cp>The competitive bidding process is an effort by the department to address persistent complaints that \u003ca href=\"https://californiahealthline.org/news/article/californias-reboot-of-troubled-medi-cal-puts-pressure-on-health-plans/\">it has not effectively monitored subpar health plans\u003c/a>.\u003c/p>\n\u003cp>Eight commercial insurers bid for Medi-Cal business in 21 counties. They were required to submit voluminous documents detailing every aspect of their operations, including past performance; the scope of their provider networks; and their capacity to meet the terms of the new, stricter contracts.\u003c/p>\n\u003cp>The new contracts contain numerous provisions intended to bolster quality, health care equity and transparency — and to boost accountability of the subcontractors to whom \u003ca href=\"https://californiahealthline.org/news/article/layers-of-subcontracted-services-confuse-and-frustrate-medi-cal-patients/\">health plans often outsource patient care\u003c/a>. For example, the plans and their subcontractors will be required to reach or exceed \u003ca href=\"https://www.dhcs.ca.gov/Documents/MCP-RFP-Issue-Brief.pdf\">the 50th percentile\u003c/a> among Medicaid plans nationally on a host of pediatric and maternal care measures — or face financial penalties.\u003c/p>\n\u003cp>They will also be on the hook for providing nonmedical social services that address socioeconomic factors, such as homelessness and food insecurity, in an ambitious $8.7 billion, \u003ca href=\"https://khn.org/news/article/california-medicaid-makeover-newsom-california-medi-cal-homeless-public-funds/\">five-year Medi-Cal initiative known as CalAIM\u003c/a>, that is already underway.\u003c/p>\n\u003cp>Local, publicly governed Medi-Cal plans, which cover about 70% of the \u003ca href=\"https://www.dhcs.ca.gov/dataandstats/statistics/Documents/FastFacts-March2022.pdf\">12.4 million Medi-Cal members who are in managed care\u003c/a>, did not participate in the bidding, though their performance has not always been top-notch. Kaiser Permanente, which this year negotiated a controversial deal with the state for an \u003ca href=\"https://californiahealthline.org/news/article/california-medicaid-contract-kaiser-permanente-key-details-missing/\">exclusive Medi-Cal contract\u003c/a> in 32 counties, was also exempt from the bidding. (KHN is not affiliated with Kaiser Permanente.)\u003c/p>\n\u003cp>But all Medi-Cal health insurers, including KP and the local plans, will have to commit to the same goals and requirements.\u003c/p>\n\u003cp>In addition to Health Net, both Blue Shield of California and Community Health Group — which have contracts with Medi-Cal only in San Diego County — are also big losers, as is Aetna, which lost bids in 10 counties.\u003c/p>\n\u003cp>Blue Shield, which lost in all 13 counties where it submitted bids, filed a fiercely worded appeal that accuses its rivals Anthem Blue Cross, Molina and Health Net of failing to disclose hundreds of millions of dollars in penalties against them. It accused those three plans of poor performance “and even mendacity” and said they filled their bids with “puffery,” which the state “bought, hook, line and sinker,” without “an iota of independent analysis.”\u003c/p>\n\u003cfigure id=\"attachment_11926773\" class=\"wp-caption alignnone\" style=\"max-width: 724px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11926773\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2022/09/GettyImages-1279766844.jpg\" alt=\"A hand in the foreground holds a card as someone reaches out to hold it from across a table.\" width=\"724\" height=\"483\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2022/09/GettyImages-1279766844.jpg 724w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/09/GettyImages-1279766844-160x107.jpg 160w\" sizes=\"(max-width: 724px) 100vw, 724px\">\u003cfigcaption class=\"wp-caption-text\">The competitive bidding process is an effort by the state Department of Health Care Services to address persistent complaints that it has not effectively monitored subpar health plans. \u003ccite>(Willie B. Thomas/Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Health Net’s appeal slammed Molina, which beat it out in LA, Sacramento, Riverside and San Bernardino counties. Molina’s bid, Health Net said, “contains false, inaccurate and misleading information.” The whole bidding process, it said, was “highly flawed,” resulting in “erroneous contract awards that jeopardize the stability of Medi-Cal.”\u003c/p>\n\u003cp>In particular, Health Net said, the Department of Health Care Services “improperly reopened the procurement” after the deadline, which allowed Molina to make “comprehensive changes” that raised its score.\u003c/p>\n\u003cp>The protesting health plans are requesting that they be awarded contracts or that the bidding process start over from scratch.\u003c/p>\n\u003cp>Joseph Garcia, chief operating officer for Community Health Group, said, “It would be easiest for all concerned if they just added us. They don’t have to remove anybody.”\u003c/p>\n\u003cp>Community Health Group has garnered an outpouring of support from hospital executives, physician groups, community clinics and the heads of multiple publicly governed Medi-Cal plans, \u003ca href=\"https://californiahealthline.org/wp-content/uploads/sites/3/2022/09/Medi-Cal-Reprocurement-Letter-of-Support-for-CHG-1.pdf\">who sent a letter to Baass\u003c/a> saying they were “shocked, concerned, and very disappointed” by the state’s decision. They called Community Health Group “our strongest partner of 40 years,” for whom “equity is not a buzzword or a new priority,” noting that more than 85% of its staff is bilingual and multicultural.\u003c/p>\n\u003cp>Community Health Group noted in its appeal that it had lost by less than a point to Health Net, which won a San Diego contract — “a minuscule difference that in itself resulted from deeply flawed scoring.”\u003c/p>\n\u003cp>Garcia said that if Community Health Group loses its appeal, it will “absolutely” sue in state court. A hearing officer appointed by Baass to consider the appeals has set deadlines to receive written responses and rebuttals by October 7.\u003c/p>\n\u003cp>There is ample precedent for protracted legal battles in bidding for Medicaid contracts. In Louisiana, Centene and Aetna \u003ca href=\"https://www.thecentersquare.com/louisiana/rejected-bidders-for-louisiana-medicaid-contracts-file-protests-alleging-bias/article_2fe6ecec-c44c-11e9-833d-331f84e9c8f0.html\">protested the results of a 2019 rebidding process\u003c/a>, which led the state to nullify its awards and restart the bidding. The \u003ca href=\"https://ldh.la.gov/news/ldh-mco-contracts\">new results\u003c/a> were announced this year, with Centene and Aetna among the winners. In Kentucky, the state court of appeals \u003ca href=\"https://www.courier-journal.com/story/news/local/2022/09/15/kentucky-medicaid-contracts-upheld-by-court-anthem-is-out-as-mco/69494863007/\">issued a ruling\u003c/a> this month in a contested Medicaid procurement that had been held two years earlier.\u003c/p>\n\u003cp>Another factor could delay the new contract: California is juggling several massive Medi-Cal changes at the same time. Among them are the implementation of CalAIM and the \u003ca href=\"https://lao.ca.gov/Publications/Report/4423\">anticipated enrollment of nearly 700,000 unauthorized immigrants age 26-49\u003c/a> by January 2024, on top of nearly a quarter-million unauthorized immigrants age 50 and older who \u003ca href=\"https://californiahealthline.org/news/article/california-medicaid-older-unauthorized-immigrants/\">became eligible this year\u003c/a>. And then there’s the recalculation of enrollees’ eligibility, which will take place whenever the federal COVID-19-related public health emergency ends. That could push \u003ca href=\"https://www.dhcs.ca.gov/Documents/PHE-UOP/Medi-Cal-COVID-19-PHE-Unwinding-Plan.pdf\">2 million to 3 million\u003c/a> Californians out of Medi-Cal.\u003c/p>\n\u003cp>“Just hearing you list all those things gave me a minor panic attack,” said Abigail Coursolle, a senior attorney at the National Health Law Program. “They are making a lot of work for themselves in a short amount of time.”\u003c/p>\n\u003cp>But, Coursolle added, the state has “a very positive vision for improving access and improving the quality of services that people in Medi-Cal receive, and that’s very important.”\u003c/p>\n\u003cp>\u003cem>California Healthline is a service of the California Health Care Foundation produced by Kaiser Health News.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"disqusTitle": "Poverty and Uninsured Rates Drop, Thanks to Pandemic-Era Policies",
"title": "Poverty and Uninsured Rates Drop, Thanks to Pandemic-Era Policies",
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"content": "\u003cp>The Census Bureau released some heartening news Tuesday.\u003c/p>\n\u003cp>Child poverty is at a historic low, according to the bureau's \u003ca href=\"https://www.census.gov/newsroom/press-releases/2022/income-poverty-health-insurance-coverage.html\">annual report\u003c/a> on income, poverty and health insurance. And the rate of Americans without health insurance also dropped in 2021 compared to the previous year.\u003c/p>\n\u003cp>But the good news may be short lived. Both gains were driven by temporary pandemic-related policies, and without action by policymakers, they could quickly unravel.\u003c/p>\n\u003ch2>Child tax credit key to drop in poverty\u003c/h2>\n\u003cp>Childhood poverty dropped substantially in 2021, falling from 9.7% in 2020 down to 5.2%. The overall poverty rate for all age groups was just under 8% — a decline from 9.2% in 2020.\u003c/p>\n\u003cp>These figures are based on the \u003ca href=\"https://www.npr.org/2011/11/07/142105558/new-measure-shows-higher-poverty-rate-in-u-s\">Supplemental Poverty Measure\u003c/a>, which takes into account all kinds of expenses families have, as well as that range of pandemic aid many families received.\u003cspan style=\"font-weight: 400\">[pullquote size=\"medium\" align=\"right\" citation=\"Sabrina Corlette, Georgetown University Center on Health Insurance Reforms\"]'As soon as the public health emergency is declared over – which could be as early as January – that safety net that was in that COVID relief bill goes away.'[/pullquote]\u003c/span>Poverty experts attribute much of this improvement to the child tax credit which Congress boosted in 2021 in the American Rescue Plan. Congress also expanded it to include millions more low-income families.\u003c/p>\n\u003cp>The child tax credit gives families more money to spend on essentials, says \u003ca href=\"https://www.cbpp.org/about/our-staff/sharon-parrott\">Sharon Parrott\u003c/a>, who has researched the issue for the Center on Budget and Policy Priorities.\u003c/p>\n\u003cp>\"They spend it on their housing, food, education, they're able to do some of those extracurricular activities that high income families take for granted,\" she says. \"They are investing in their kids and their families are able to make ends meet in really important ways.\"\u003c/p>\n\u003cp>And Parrott says all these things can have long term benefits for kids, like doing better in school and being healthier.\u003c/p>\n\u003ch2>Uninsured rate approaches record lows, thanks to Medicaid\u003c/h2>\n\u003cp>The census numbers show 8.3% of Americans – or 27.2 million people – did not have any health insurance in 2021. That's an improvement from 2020, when 8.6% of people were uninsured.\u003c/p>\n\u003cp>The force behind this trend is Medicaid, the public health insurance option for people with low incomes, according to census officials who briefed reporters Tuesday.\u003c/p>\n\u003cp>\"The reason the Medicaid rates have increased is because of a COVID relief bill that Congress passed in March of 2020,\" says \u003ca href=\"https://chir.georgetown.edu/faculty_sabrina_corlette/\">Sabrina Corlette\u003c/a> of the Georgetown University Center on Health Insurance Reforms.\u003c/p>\n\u003cp>The Families First Coronavirus Response Act essentially mandated that state Medicaid programs not force enrollees to requalify for the program – so states could enroll new people but not kick anyone off. Because of this \"continuous enrollment provision,\" Medicaid has grown significantly.\u003c/p>\n\u003cp>Another area of growth was Medicare, though census officials noted that that's due to more people turning 65 and becoming eligible, not because of a policy change.\u003c/p>\n\u003ch2>What happens when pandemic measures end\u003c/h2>\n\u003cp>Policy experts say this week's good news may be fleeting. The expanded child tax credit ended in December, just as inflation was starting to climb to historic highs. The policy supporting more people getting health insurance is set to run out in a few months.\u003c/p>\n\u003cp>\"As soon as the public health emergency is declared over – which could be as early as January – that safety net that was in that COVID relief bill goes away,\" says Corlette. \"And so we could see this historic increase in the rates of the insured be reversed.\"\u003cspan style=\"font-weight: 400\">[aside label='Related Articles' tag='poverty']\u003c/span>More than 15 million people could lose Medicaid, according to an estimate from the Department of Health and Human Services \u003ca href=\"https://aspe.hhs.gov/sites/default/files/documents/60f0ac74ee06eb578d30b0f39ac94323/aspe-end-mcaid-continuous-coverage.pdf?_ga=2.168159075.310828479.1663022160-418932185.1663022160\">released last month\u003c/a>. The analysis suggests nearly half of those losing coverage will be because of administrative issues – such as challenges with filling out the paperwork to reapply – and not because they no longer qualify for coverage. Some will be able to get coverage elsewhere, but millions more may become uninsured.\u003c/p>\n\u003cp>When it comes to poverty, inflation could start to affect these rates. In fact, one group already is seeing more poverty in the 2021 numbers and that is seniors. Census officials say this is likely because they're on fixed incomes, and already last year inflation was starting to tick up, really squeezing their budgets.\u003c/p>\n\u003cp>But again, Census officials stressed that Social Security did keep more than 26 million people out of poverty, and that includes several million children being raised by grandparents.\u003c/p>\n\u003ch2>How to hold on to temporary gains\u003c/h2>\n\u003cp>In terms of U.S. trends over time, the Census numbers released Tuesday on child poverty and health insurance are encouraging, experts say, and it's now up to policymakers to act to keep these gains.\u003c/p>\n\u003cp>\"Any of the improvements that we see – whether it's insurance or poverty – are a reflection of political choices,\" says \u003ca href=\"https://government.cornell.edu/jamila-michener\">Jamila Michener\u003c/a> – a professor of government at Cornell and an expert on Medicaid.\u003c/p>\n\u003cp>The Biden administration and many Democrats would like to make the expanded child tax credit permanent. The U.S. House passed such a measure but it did not survive in the Senate. Several Republican Senators have proposed more limited ways to expand the child tax credit.\u003c/p>\n\u003cp>\"What we don't know is the trade-offs,\" says Angela Rachidi, a senior fellow at the American Enterprise Institute. \"We know inflation increased dramatically over the past year. To what extent did all this government transfer of income contribute to that, I think, is still a question.\"\u003c/p>\n\u003cp>Some researchers note that the U.S. has a long way to go with gains in health and insurance rates, when compared to similar high-income countries.\u003c/p>\n\u003cp>\"[Among] our peer countries, we have one of the highest rates of uninsurance in the world and also poorer health outcomes,\" notes Corlette. \"And that's been an issue for us even before the pandemic.\"\u003c/p>\n\u003cp>A \u003ca href=\"https://nap.nationalacademies.org/catalog/13497/us-health-in-international-perspective-shorter-lives-poorer-health\">landmark study in 2013\u003c/a> enumerated the many ways Americans don't have as healthy or long lives as people do in similarly wealthy countries.\u003c/p>\n\u003cp>One striking illustration of this came with the new life expectancy numbers released two weeks ago. Countries all over the world had a drop in life expectancy after the first year of the pandemic, but many have been able to rebound.\u003c/p>\n\u003cp>America has not – instead life expectancy \u003ca href=\"https://www.npr.org/sections/health-shots/2022/08/31/1120192583/life-expectancy-in-the-u-s-continues-to-drop-driven-by-covid-19\">dropped for two years\u003c/a> in a row, the first time that's happened in the U.S. in a century.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>The Census Bureau released some heartening news Tuesday.\u003c/p>\n\u003cp>Child poverty is at a historic low, according to the bureau's \u003ca href=\"https://www.census.gov/newsroom/press-releases/2022/income-poverty-health-insurance-coverage.html\">annual report\u003c/a> on income, poverty and health insurance. And the rate of Americans without health insurance also dropped in 2021 compared to the previous year.\u003c/p>\n\u003cp>But the good news may be short lived. Both gains were driven by temporary pandemic-related policies, and without action by policymakers, they could quickly unravel.\u003c/p>\n\u003ch2>Child tax credit key to drop in poverty\u003c/h2>\n\u003cp>Childhood poverty dropped substantially in 2021, falling from 9.7% in 2020 down to 5.2%. The overall poverty rate for all age groups was just under 8% — a decline from 9.2% in 2020.\u003c/p>\n\u003cp>These figures are based on the \u003ca href=\"https://www.npr.org/2011/11/07/142105558/new-measure-shows-higher-poverty-rate-in-u-s\">Supplemental Poverty Measure\u003c/a>, which takes into account all kinds of expenses families have, as well as that range of pandemic aid many families received.\u003cspan style=\"font-weight: 400\">\u003c/p>\u003c/div>",
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"content": "'As soon as the public health emergency is declared over – which could be as early as January – that safety net that was in that COVID relief bill goes away.'",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/span>Poverty experts attribute much of this improvement to the child tax credit which Congress boosted in 2021 in the American Rescue Plan. Congress also expanded it to include millions more low-income families.\u003c/p>\n\u003cp>The child tax credit gives families more money to spend on essentials, says \u003ca href=\"https://www.cbpp.org/about/our-staff/sharon-parrott\">Sharon Parrott\u003c/a>, who has researched the issue for the Center on Budget and Policy Priorities.\u003c/p>\n\u003cp>\"They spend it on their housing, food, education, they're able to do some of those extracurricular activities that high income families take for granted,\" she says. \"They are investing in their kids and their families are able to make ends meet in really important ways.\"\u003c/p>\n\u003cp>And Parrott says all these things can have long term benefits for kids, like doing better in school and being healthier.\u003c/p>\n\u003ch2>Uninsured rate approaches record lows, thanks to Medicaid\u003c/h2>\n\u003cp>The census numbers show 8.3% of Americans – or 27.2 million people – did not have any health insurance in 2021. That's an improvement from 2020, when 8.6% of people were uninsured.\u003c/p>\n\u003cp>The force behind this trend is Medicaid, the public health insurance option for people with low incomes, according to census officials who briefed reporters Tuesday.\u003c/p>\n\u003cp>\"The reason the Medicaid rates have increased is because of a COVID relief bill that Congress passed in March of 2020,\" says \u003ca href=\"https://chir.georgetown.edu/faculty_sabrina_corlette/\">Sabrina Corlette\u003c/a> of the Georgetown University Center on Health Insurance Reforms.\u003c/p>\n\u003cp>The Families First Coronavirus Response Act essentially mandated that state Medicaid programs not force enrollees to requalify for the program – so states could enroll new people but not kick anyone off. Because of this \"continuous enrollment provision,\" Medicaid has grown significantly.\u003c/p>\n\u003cp>Another area of growth was Medicare, though census officials noted that that's due to more people turning 65 and becoming eligible, not because of a policy change.\u003c/p>\n\u003ch2>What happens when pandemic measures end\u003c/h2>\n\u003cp>Policy experts say this week's good news may be fleeting. The expanded child tax credit ended in December, just as inflation was starting to climb to historic highs. The policy supporting more people getting health insurance is set to run out in a few months.\u003c/p>\n\u003cp>\"As soon as the public health emergency is declared over – which could be as early as January – that safety net that was in that COVID relief bill goes away,\" says Corlette. \"And so we could see this historic increase in the rates of the insured be reversed.\"\u003cspan style=\"font-weight: 400\">\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/span>More than 15 million people could lose Medicaid, according to an estimate from the Department of Health and Human Services \u003ca href=\"https://aspe.hhs.gov/sites/default/files/documents/60f0ac74ee06eb578d30b0f39ac94323/aspe-end-mcaid-continuous-coverage.pdf?_ga=2.168159075.310828479.1663022160-418932185.1663022160\">released last month\u003c/a>. The analysis suggests nearly half of those losing coverage will be because of administrative issues – such as challenges with filling out the paperwork to reapply – and not because they no longer qualify for coverage. Some will be able to get coverage elsewhere, but millions more may become uninsured.\u003c/p>\n\u003cp>When it comes to poverty, inflation could start to affect these rates. In fact, one group already is seeing more poverty in the 2021 numbers and that is seniors. Census officials say this is likely because they're on fixed incomes, and already last year inflation was starting to tick up, really squeezing their budgets.\u003c/p>\n\u003cp>But again, Census officials stressed that Social Security did keep more than 26 million people out of poverty, and that includes several million children being raised by grandparents.\u003c/p>\n\u003ch2>How to hold on to temporary gains\u003c/h2>\n\u003cp>In terms of U.S. trends over time, the Census numbers released Tuesday on child poverty and health insurance are encouraging, experts say, and it's now up to policymakers to act to keep these gains.\u003c/p>\n\u003cp>\"Any of the improvements that we see – whether it's insurance or poverty – are a reflection of political choices,\" says \u003ca href=\"https://government.cornell.edu/jamila-michener\">Jamila Michener\u003c/a> – a professor of government at Cornell and an expert on Medicaid.\u003c/p>\n\u003cp>The Biden administration and many Democrats would like to make the expanded child tax credit permanent. The U.S. House passed such a measure but it did not survive in the Senate. Several Republican Senators have proposed more limited ways to expand the child tax credit.\u003c/p>\n\u003cp>\"What we don't know is the trade-offs,\" says Angela Rachidi, a senior fellow at the American Enterprise Institute. \"We know inflation increased dramatically over the past year. To what extent did all this government transfer of income contribute to that, I think, is still a question.\"\u003c/p>\n\u003cp>Some researchers note that the U.S. has a long way to go with gains in health and insurance rates, when compared to similar high-income countries.\u003c/p>\n\u003cp>\"[Among] our peer countries, we have one of the highest rates of uninsurance in the world and also poorer health outcomes,\" notes Corlette. \"And that's been an issue for us even before the pandemic.\"\u003c/p>\n\u003cp>A \u003ca href=\"https://nap.nationalacademies.org/catalog/13497/us-health-in-international-perspective-shorter-lives-poorer-health\">landmark study in 2013\u003c/a> enumerated the many ways Americans don't have as healthy or long lives as people do in similarly wealthy countries.\u003c/p>\n\u003cp>One striking illustration of this came with the new life expectancy numbers released two weeks ago. Countries all over the world had a drop in life expectancy after the first year of the pandemic, but many have been able to rebound.\u003c/p>\n\u003cp>America has not – instead life expectancy \u003ca href=\"https://www.npr.org/sections/health-shots/2022/08/31/1120192583/life-expectancy-in-the-u-s-continues-to-drop-driven-by-covid-19\">dropped for two years\u003c/a> in a row, the first time that's happened in the U.S. in a century.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>About 40,000 undocumented adults with low incomes won't lose their government-funded health insurance over the next year under a new policy announced Monday by Gov. Gavin Newsom's administration.\u003c/p>\n\u003cp>California already pays for the health care expenses of lower-income adults age 25 and younger, regardless of their immigration status. A new law scheduled to take effect in January 2024 would extend those benefits to cover all adults who, but for their immigration status, would qualify for the state's Medicaid program.\u003c/p>\n\u003cp>[aside label=\"Related Stories\" postID=\"news_11914800,news_11882852,news_11879266\"]But between now and when that new law takes effect in 2024, about 40,000 young adults who already have Medicaid in California are expected to lose their benefits because they are older than 25. Monday, the state Department of Health Care Services announced it would continue to cover those young adults through the end of 2023 to make sure they won't lose their benefits.\u003c/p>\n\u003cp>“Providing continuous coverage means that tens of thousands of young Californians won’t face a disruption in care, keeping them covered and healthier as a result,” said Jose Torres Casillas, policy and legislative advocate for Health Access California, a consumer health care advocacy group. “California is again leading the way in making our health care system work better for all communities, regardless of income, age or immigration status.”\u003c/p>\n\u003cp>Nationwide, about 22.1 million people, or about 7% of the population, were undocumented in 2020, according to the Kaiser Family Foundation, a health care nonprofit. They are not eligible for most federal public benefit programs, even though many have jobs and pay taxes.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Some states, including California, have used their own money to cover the health care expenses of this group. Eighteen states provide prenatal care to people regardless of their immigration status, while five states and the District of Columbia cover all children from lower-income families regardless of their immigration status. California and Illinois recently made older adult immigrants eligible for their Medicaid programs.\u003c/p>\n\u003cp>California was the first state to pay for the health care expenses of some undocumented adults when, in 2019, state lawmakers voted to make people 25 and younger eligible for Medicaid regardless of their immigration status.\u003c/p>\n\u003cp>That policy took effect in 2020, right when the COVID-19 pandemic started. The federal government issued a public health emergency, meaning no one could lose their Medicaid benefits. That's why lots of young immigrants in California have been able to stay on Medicaid, even though they are now older than 25 and are technically no longer eligible.\u003c/p>\n\u003cp>The federal public health emergency is expected to end soon. When it does, all of those young adults who are now older than 25 would lose their benefits once they came up for renewal. Instead, the Newsom administration said it would delay those renewals until the end of 2023, giving them time for the new law to take effect.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“Protecting these young adults — who currently have Medi-Cal — from losing coverage, only to become eligible again shortly thereafter, will prevent needless gaps in health care services and medication that people need,\" said Connie Choi, policy director at the California Immigrant Policy Center.\u003c/p>\n\n",
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"rss": "https://podcasts.files.bbci.co.uk/p02nq0gn.rss"
}
},
"californiareport": {
"id": "californiareport",
"title": "The California Report",
"tagline": "California, day by day",
"info": "KQED’s statewide radio news program providing daily coverage of issues, trends and public policy decisions.",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/The-California-Report-Podcast-Tile-703x703-1.jpg",
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"officialWebsiteLink": "/californiareport",
"meta": {
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"source": "kqed",
"order": 8
},
"link": "/californiareport",
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}
},
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"id": "californiareportmagazine",
"title": "The California Report Magazine",
"tagline": "Your state, your stories",
"info": "Every week, The California Report Magazine takes you on a road trip for the ears: to visit the places and meet the people who make California unique. The in-depth storytelling podcast from the California Report.",
"airtime": "FRI 4:30pm-5pm, 6:30pm-7pm, 11pm-11:30pm",
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"officialWebsiteLink": "/californiareportmagazine",
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"order": 10
},
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"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkM3NjkwNjk1OTAz",
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}
},
"city-arts": {
"id": "city-arts",
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"info": "A one-hour radio program to hear celebrated writers, artists and thinkers address contemporary ideas and values, often discussing the creative process. Please note: tapes or transcripts are not available",
"imageSrc": "https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/05/cityartsandlecture-300x300.jpg",
"officialWebsiteLink": "https://www.cityarts.net/",
"airtime": "SUN 1pm-2pm, TUE 10pm, WED 1am",
"meta": {
"site": "news",
"source": "City Arts & Lectures"
},
"link": "https://www.cityarts.net",
"subscribe": {
"tuneIn": "https://tunein.com/radio/City-Arts-and-Lectures-p692/",
"rss": "https://www.cityarts.net/feed/"
}
},
"closealltabs": {
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"info": "Close All Tabs breaks down how digital culture shapes our world through thoughtful insights and irreverent humor.",
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"officialWebsiteLink": "/podcasts/closealltabs",
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"order": 1
},
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"title": "Code Switch / Life Kit",
"info": "\u003cem>Code Switch\u003c/em>, which listeners will hear in the first part of the hour, has fearless and much-needed conversations about race. Hosted by journalists of color, the show tackles the subject of race head-on, exploring how it impacts every part of society — from politics and pop culture to history, sports and more.\u003cbr />\u003cbr />\u003cem>Life Kit\u003c/em>, which will be in the second part of the hour, guides you through spaces and feelings no one prepares you for — from finances to mental health, from workplace microaggressions to imposter syndrome, from relationships to parenting. The show features experts with real world experience and shares their knowledge. Because everyone needs a little help being human.\u003cbr />\u003cbr />\u003ca href=\"https://www.npr.org/podcasts/510312/codeswitch\">\u003cem>Code Switch\u003c/em> offical site and podcast\u003c/a>\u003cbr />\u003ca href=\"https://www.npr.org/lifekit\">\u003cem>Life Kit\u003c/em> offical site and podcast\u003c/a>\u003cbr />",
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"meta": {
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"google": "https://podcasts.google.com/feed/aHR0cHM6Ly93d3cubnByLm9yZy9yc3MvcG9kY2FzdC5waHA_aWQ9NTEwMzEy",
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"id": "commonwealth-club",
"title": "Commonwealth Club of California Podcast",
"info": "The Commonwealth Club of California is the nation's oldest and largest public affairs forum. As a non-partisan forum, The Club brings to the public airwaves diverse viewpoints on important topics. The Club's weekly radio broadcast - the oldest in the U.S., dating back to 1924 - is carried across the nation on public radio stations and is now podcasting. Our website archive features audio of our recent programs, as well as selected speeches from our long and distinguished history. This podcast feed is usually updated twice a week and is always un-edited.",
"airtime": "THU 10pm, FRI 1am",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Commonwealth-Club-Podcast-Tile-360x360-1.jpg",
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"meta": {
"site": "news",
"source": "Commonwealth Club of California"
},
"link": "/radio/program/commonwealth-club",
"subscribe": {
"apple": "https://itunes.apple.com/us/podcast/commonwealth-club-of-california-podcast/id976334034?mt=2",
"google": "https://podcasts.google.com/feed/aHR0cDovL3d3dy5jb21tb253ZWFsdGhjbHViLm9yZy9hdWRpby9wb2RjYXN0L3dlZWtseS54bWw",
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}
},
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"id": "forum",
"title": "Forum",
"tagline": "The conversation starts here",
"info": "KQED’s live call-in program discussing local, state, national and international issues, as well as in-depth interviews.",
"airtime": "MON-FRI 9am-11am, 10pm-11pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Forum-Podcast-Tile-703x703-1.jpg",
"imageAlt": "KQED Forum with Mina Kim and Alexis Madrigal",
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"meta": {
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"source": "kqed",
"order": 9
},
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"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkM5NTU3MzgxNjMz",
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"id": "freakonomics-radio",
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"imageSrc": "https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/05/freakonomicsRadio.png",
"officialWebsiteLink": "http://freakonomics.com/",
"airtime": "SUN 1am-2am, SAT 3pm-4pm",
"meta": {
"site": "radio",
"source": "WNYC"
},
"link": "/radio/program/freakonomics-radio",
"subscribe": {
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"apple": "https://itunes.apple.com/us/podcast/freakonomics-radio/id354668519",
"tuneIn": "https://tunein.com/podcasts/WNYC-Podcasts/Freakonomics-Radio-p272293/",
"rss": "https://feeds.feedburner.com/freakonomicsradio"
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},
"fresh-air": {
"id": "fresh-air",
"title": "Fresh Air",
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"apple": "https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?s=143441&mt=2&id=214089682&at=11l79Y&ct=nprdirectory",
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"rss": "https://feeds.npr.org/381444908/podcast.xml"
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"info": "A live production of NPR and WBUR Boston, in collaboration with stations across the country, Here & Now reflects the fluid world of news as it's happening in the middle of the day, with timely, in-depth news, interviews and conversation. Hosted by Robin Young, Jeremy Hobson and Tonya Mosley.",
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"rss": "https://feeds.npr.org/510051/podcast.xml"
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},
"hidden-brain": {
"id": "hidden-brain",
"title": "Hidden Brain",
"info": "Shankar Vedantam uses science and storytelling to reveal the unconscious patterns that drive human behavior, shape our choices and direct our relationships.",
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"officialWebsiteLink": "https://www.npr.org/series/423302056/hidden-brain",
"airtime": "SUN 7pm-8pm",
"meta": {
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"source": "NPR"
},
"link": "/radio/program/hidden-brain",
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},
"how-i-built-this": {
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"title": "How I Built This with Guy Raz",
"info": "Guy Raz dives into the stories behind some of the world's best known companies. How I Built This weaves a narrative journey about innovators, entrepreneurs and idealists—and the movements they built.",
"imageSrc": "https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/05/howIBuiltThis.png",
"officialWebsiteLink": "https://www.npr.org/podcasts/510313/how-i-built-this",
"airtime": "SUN 7:30pm-8pm",
"meta": {
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"source": "npr"
},
"link": "/radio/program/how-i-built-this",
"subscribe": {
"npr": "https://rpb3r.app.goo.gl/3zxy",
"apple": "https://itunes.apple.com/us/podcast/how-i-built-this-with-guy-raz/id1150510297?mt=2",
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},
"hyphenacion": {
"id": "hyphenacion",
"title": "Hyphenación",
"tagline": "Where conversation and cultura meet",
"info": "What kind of no sabo word is Hyphenación? For us, it’s about living within a hyphenation. Like being a third-gen Mexican-American from the Texas border now living that Bay Area Chicano life. Like Xorje! Each week we bring together a couple of hyphenated Latinos to talk all about personal life choices: family, careers, relationships, belonging … everything is on the table. ",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2025/03/Hyphenacion_FinalAssets_PodcastTile.png",
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"officialWebsiteLink": "/podcasts/hyphenacion",
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"order": 15
},
"link": "/podcasts/hyphenacion",
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"spotify": "https://open.spotify.com/show/2p3Fifq96nw9BPcmFdIq0o?si=39209f7b25774f38",
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"rss": "https://feeds.megaphone.fm/KQINC2275451163"
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},
"jerrybrown": {
"id": "jerrybrown",
"title": "The Political Mind of Jerry Brown",
"tagline": "Lessons from a lifetime in politics",
"info": "The Political Mind of Jerry Brown brings listeners the wisdom of the former Governor, Mayor, and presidential candidate. Scott Shafer interviewed Brown for more than 40 hours, covering the former governor's life and half-century in the political game – and Brown has some lessons he'd like to share. ",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/The-Political-Mind-of-Jerry-Brown-Podcast-Tile-703x703-1.jpg",
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"officialWebsiteLink": "/podcasts/jerrybrown",
"meta": {
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"source": "kqed",
"order": 18
},
"link": "/podcasts/jerrybrown",
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"apple": "https://itunes.apple.com/us/podcast/id1492194549",
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}
},
"latino-usa": {
"id": "latino-usa",
"title": "Latino USA",
"airtime": "MON 1am-2am, SUN 6pm-7pm",
"info": "Latino USA, the radio journal of news and culture, is the only national, English-language radio program produced from a Latino perspective.",
"imageSrc": "https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/latinoUsa.jpg",
"officialWebsiteLink": "http://latinousa.org/",
"meta": {
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"source": "npr"
},
"link": "/radio/program/latino-usa",
"subscribe": {
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"apple": "https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?s=143441&mt=2&id=79681317&at=11l79Y&ct=nprdirectory",
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"rss": "https://feeds.npr.org/510016/podcast.xml"
}
},
"marketplace": {
"id": "marketplace",
"title": "Marketplace",
"info": "Our flagship program, helmed by Kai Ryssdal, examines what the day in money delivered, through stories, conversations, newsworthy numbers and more. Updated Monday through Friday at about 3:30 p.m. PT.",
"airtime": "MON-FRI 4pm-4:30pm, MON-WED 6:30pm-7pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Marketplace-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://www.marketplace.org/",
"meta": {
"site": "news",
"source": "American Public Media"
},
"link": "/radio/program/marketplace",
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"rss": "https://feeds.publicradio.org/public_feeds/marketplace-pm/rss/rss"
}
},
"masters-of-scale": {
"id": "masters-of-scale",
"title": "Masters of Scale",
"info": "Masters of Scale is an original podcast in which LinkedIn co-founder and Greylock Partner Reid Hoffman sets out to describe and prove theories that explain how great entrepreneurs take their companies from zero to a gazillion in ingenious fashion.",
"airtime": "Every other Wednesday June 12 through October 16 at 8pm (repeats Thursdays at 2am)",
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"officialWebsiteLink": "https://mastersofscale.com/",
"meta": {
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"source": "WaitWhat"
},
"link": "/radio/program/masters-of-scale",
"subscribe": {
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"rss": "https://rss.art19.com/masters-of-scale"
}
},
"mindshift": {
"id": "mindshift",
"title": "MindShift",
"tagline": "A podcast about the future of learning and how we raise our kids",
"info": "The MindShift podcast explores the innovations in education that are shaping how kids learn. Hosts Ki Sung and Katrina Schwartz introduce listeners to educators, researchers, parents and students who are developing effective ways to improve how kids learn. We cover topics like how fed-up administrators are developing surprising tactics to deal with classroom disruptions; how listening to podcasts are helping kids develop reading skills; the consequences of overparenting; and why interdisciplinary learning can engage students on all ends of the traditional achievement spectrum. This podcast is part of the MindShift education site, a division of KQED News. KQED is an NPR/PBS member station based in San Francisco. You can also visit the MindShift website for episodes and supplemental blog posts or tweet us \u003ca href=\"https://twitter.com/MindShiftKQED\">@MindShiftKQED\u003c/a> or visit us at \u003ca href=\"/mindshift\">MindShift.KQED.org\u003c/a>",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Mindshift-Podcast-Tile-703x703-1.jpg",
"imageAlt": "KQED MindShift: How We Will Learn",
"officialWebsiteLink": "/mindshift/",
"meta": {
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"source": "kqed",
"order": 12
},
"link": "/podcasts/mindshift",
"subscribe": {
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"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkM1NzY0NjAwNDI5",
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"stitcher": "https://www.stitcher.com/podcast/kqed/stories-teachers-share",
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}
},
"morning-edition": {
"id": "morning-edition",
"title": "Morning Edition",
"info": "\u003cem>Morning Edition\u003c/em> takes listeners around the country and the world with multi-faceted stories and commentaries every weekday. Hosts Steve Inskeep, David Greene and Rachel Martin bring you the latest breaking news and features to prepare you for the day.",
"airtime": "MON-FRI 3am-9am",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Morning-Edition-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://www.npr.org/programs/morning-edition/",
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"link": "/radio/program/morning-edition"
},
"onourwatch": {
"id": "onourwatch",
"title": "On Our Watch",
"tagline": "Deeply-reported investigative journalism",
"info": "For decades, the process for how police police themselves has been inconsistent – if not opaque. In some states, like California, these proceedings were completely hidden. After a new police transparency law unsealed scores of internal affairs files, our reporters set out to examine these cases and the shadow world of police discipline. On Our Watch brings listeners into the rooms where officers are questioned and witnesses are interrogated to find out who this system is really protecting. Is it the officers, or the public they've sworn to serve?",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/On-Our-Watch-Podcast-Tile-703x703-1.jpg",
"imageAlt": "On Our Watch from NPR and KQED",
"officialWebsiteLink": "/podcasts/onourwatch",
"meta": {
"site": "news",
"source": "kqed",
"order": 11
},
"link": "/podcasts/onourwatch",
"subscribe": {
"apple": "https://podcasts.apple.com/podcast/id1567098962",
"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5ucHIub3JnLzUxMDM2MC9wb2RjYXN0LnhtbD9zYz1nb29nbGVwb2RjYXN0cw",
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"spotify": "https://open.spotify.com/show/0OLWoyizopu6tY1XiuX70x",
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"stitcher": "https://www.stitcher.com/show/on-our-watch",
"rss": "https://feeds.npr.org/510360/podcast.xml"
}
},
"on-the-media": {
"id": "on-the-media",
"title": "On The Media",
"info": "Our weekly podcast explores how the media 'sausage' is made, casts an incisive eye on fluctuations in the marketplace of ideas, and examines threats to the freedom of information and expression in America and abroad. For one hour a week, the show tries to lift the veil from the process of \"making media,\" especially news media, because it's through that lens that we see the world and the world sees us",
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"info": "One of public radio's most dynamic voices, Sam Sanders helped launch The NPR Politics Podcast and hosted NPR's hit show It's Been A Minute. Now, the award-winning host returns with something brand new, The Sam Sanders Show. Every week, Sam Sanders and friends dig into the culture that shapes our lives: what's driving the biggest trends, how artists really think, and even the memes you can't stop scrolling past. Sam is beloved for his way of unpacking the world and bringing you up close to fresh currents and engaging conversations. The Sam Sanders Show is smart, funny and always a good time.",
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