Medi-Cal backlog puts low-income patients in limbo

  • At the Petaluma Health Center, Elizabeth Barton of Petaluma has her blood drawn by phlebotomist Rebecca Alvarado. Barton waited for nearly three hours for the test as the Health Center helped her with paperwork from Medi-Cal on Wednesday, Aug. 8, 2014. (Kent Porter / Press Democrat) 2014

Beth Barton’s medical bills continue to pile up from emergency room visits, prescriptions and tests. The progression of a genetic disease called Ehlers-Danlos syndrome, which slowly breaks down connective tissues in Barton’s skin, joints and blood vessels, means the freelance photographer can only work a few hours a month.

Prior to this year, Barton couldn’t afford medical insurance as an adult because her ailments stamped her with a pre-existing condition. But President Barack Obama’s health care overhaul meant Barton would qualify for coverage after signing up for Medi-Cal, the state’s low-income health care program. Then she could find a primary care physician.

But those plans have been on hold for Barton and hundreds of thousands of poor residents of California, where the enrollment backlog for Medi-Cal has resulted in diminished or delayed health care for some of the most needy. The waiting list for those who became newly eligible for the free coverage on Jan. 1 is now at about 600,000 people statewide, including at least 12,500 residents of Sonoma County.

The wait has forced people to postpone care, pay out of pocket for medical costs or sacrifice other living essentials, including food and housing.

Barton, 30, of Petaluma said she is barely hanging on.

“Medi-Cal was my saving grace,” she said. “I applied in Sonoma County before Christmas, because I kept getting sicker and sicker. I called and kept calling. Then March came. Then April came. I’m still waiting. Now it looks like I’ll have to start all over.”

Eight months after California opened up its low-income health program to millions of poor people, data gathered this summer show that in Sonoma County, more than half of newly eligible county residents who have applied for Medi-Cal benefits since Jan. 1 are still waiting for coverage.

Applications for roughly 12,565 of the county’s 18,000 previously uninsured people, many of whom are teetering on the brink of poverty, are stuck in the backlog.

State and county health officials blame the delay on technology glitches, combined with a record number of Californians seeking Medi-Cal. State officials have set a goal to deal with those glitches and reduce the backlog nearly in half by September. Officials with the state Department of Health Care Services deferred to a July 14 letter that summarized that response and offered few additional details about the problem and the state’s strategy to address it.

The state has not released data showing the county- by-county breakdown of the backlog. Officials said they were still reviewing the data for any violations of patient privacy.

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