Tens of thousands still waiting for Medi-Cal coverage

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State officials have been working for months to clear a backlog of Medi-Cal applications that at one point stood at close to one million. They've made progress, but about 170,000 applications remain.

State and federal law require the state to process Medi-Cal applications within 45 days, but all of the remaining applications have been sitting around longer than that. In fact, most have been waiting six months or more to be processed. Some low-income Californians have been waiting more than a year for a decision on their health coverage.

In an email, California Department of Healthcare Services spokesman Norman Williams said the agency is working hard to clear the backlog. In late September, it stood at about 250,000 applications, he said.

Williams estimated that about one quarter of the remaining 170,000 applications are duplicates that have to be removed from the system, while some are missing required documents such as pay stubs.

In a July letter to the federal government, the state acknowledged that it was not prepared for the huge surge in Medi-Cal applications it received early this year after the Affordable Care Act expanded eligibility for the program. Its computer systems for processing the applications have been plagued by glitches.

After months of prodding officials to speed up the process, advocates for the poor got fed up and sued the state. Their lawsuit detailed the story of a Visalia man who died of a pulmonary embolism after he had waited months for his Medi-Cal to be approved, only to have the approval arrive in the mail after his death.

Williams said officials are considering a fix that could help clear the backlog more quickly. He said California may grant temporary coverage to Medi-Cal applicants younger than 19, until the state can make a final decision on their applications. But he said a decision has yet to be made about whether the state will actually go forward with the plan.

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