Nearly a Million Medicaid Applications Backlogged in California


In California, nearly a million applications for the state’s Medicaid insurance program remain stalled in the system’s purgatory, with little sign of budging.

The massive backlog was first reported in April, when the California Department of Health Care Services said that 800,000 applications for enrollment were waiting to be processed. The number grew to over 900,000 by May and hasn’t changed in the last two months, as bureaucrats struggle to keep up with the inundation. According to the San Jose Mercury News, officials have also confirmed that the state has fallen behind in “sending final notifications to enrollees.”

The Medicaid program, called Medi-Cal, provides much-needed health care to a range of people, including those who are low-income and individuals with disabilities and certain diseases, such as HIV, AIDS, and breast cancer. As part of the Affordable Care Act, California expanded Medi-Cal on the first day of this year, making significantly more people eligible for the government-funded health insurance program. People newly eligible for Medi-Cal were able to apply for enrollment last fall through the state’s online health insurance marketplace.

By and large, the population most likely to benefit from Medi-Cal is Latinos. In 2012, seven million Californians (or one in five people in the state) were uninsured. Almost 30 percent of Latinos in California are uninsured, compared with 17 percent of African Americans and about 14 percent of white people. Latinos make up 40 percent of the population of California, but almost 60 percent of the uninsured individuals in the state. Additionally, the Department of Health Care Services estimates that about 40 percent of people eligible for Medi-Cal are Latino, and nearly 20 percent speak Spanish as their primary language.

At least part of the bottleneck can be attributed to the number of people enrolling. Before the expansion, there were 8.5 million Americans using Medi-Cal for health insurance. According to the local paper, an additional 2.2 million people will have signed up by the end of the month—300,000 more than originally projected.

Since last fall, 40 percent more people have signed up for Medi-Cal than the number who enrolled in private insurance through Covered California, the state’s health insurance exchange. Roughly 1.4 million of those applicants were newly eligible for Medi-Cal, which was expanded to serve people up to 138 percent of the federal poverty level. About 600,000 more were previously eligible for coverage but had not enrolled.

The giant system backlog means that many state residents eligible for Medi-Cal aren’t receiving the care they need. Multiple sources report that people hoping to be covered through the program are putting off going to a doctor until their enrollment is confirmed.

California is not the only state experiencing backlogs in Medicaid enrollment this year. Illinois faces the next biggest pile-up, while Florida, Texas, and North Carolina have each reported backlogs of at least 10,000.

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