Every year, low-income Californians must renew their Medi-Cal coverage by proving they still qualify for the program. But for undocumented immigrants, this year, the process has higher stakes. Because of new state policies, if they miss their renewal timeframe, they won\u2019t be able to recover coverage later. <\/p>\n\n\n\n
That\u2019s where San Francisco\u2019s community clinics come in. For decades, these clinics have helped their immigrant patient base figure out how to access affordable healthcare in San Francisco. When the state began expanding Medi-Cal access for undocumented Californians over the past decade, they strived to connect as many people as they could to the free and low-cost insurance program. <\/p>\n\n\n\n
Now, staff at the clinics are racing against the clock to make sure these same immigrants stay enrolled. <\/p>\n\n\n\n
Facing a budget deficit, California froze<\/a> Medi-Cal enrollment last June for adults with \u201cunsatisfactory\u201d immigration status<\/a> last June. Since January, only those already enrolled in Medi-Cal can keep the coverage, making renewals critical. <\/p>\n\n\n\n But for many immigrants, navigating the renewal process has become more complicated under the new rules.<\/p>\n\n\n\n \u201cThere are now really strict time limits within which we can reapply,” said Jesus Martell Gonz\u00e1lez, chief operations officer at Mission Neighborhood Health Center (MNHC). “But there is hope. And we’re here to help people.\u201d <\/p>\n\n\n\n About 90 days before their coverage expires, Medi-Cal sends patients a renewal packet in a yellow envelope they need to submit in order to keep the public health insurance for another year. <\/p>\n\n\n\n Residents can renew Medi-Cal on their own<\/a>, either online<\/a> or via phone call: (855) 355-5757. After coverage ends, they also have<\/a> a 90-day grace period to get it back before they are unenrolled. <\/p>\n\n\n\n Still, healthcare advocates note that their immigrant patients often face language and cultural barriers that can slow down or stall their renewal process. <\/p>\n\n\n\n Some people have moved homes and forgotten to update their new address, so they miss the renewal notices, explained Cynthia Campos, a Health Enrollment Navigator with MNHC. Other patients might not be aware how the Medi-Cal process works, or get confused and overwhelmed by the new restrictions and requirements. <\/p>\n\n\n\n Community clinics around the city have dedicated staff to help patients with renewals during one-on-one appointments. They can explain the forms in multiple languages and suggest alternative documentation to provide, for instance, if people are paid under the table or have variable income. They can print out documents for patients and help mail them out. They also help break down the new restrictions and policies. <\/p>\n\n\n\n \u201cSome [patients] are just scared that they won\u2019t even qualify no more because of the new restrictions that they put,\u201d Campos said. \u201cThey right off the bat assume \u2018Oh, I\u2019m not eligible,\u2019 but we go ahead and tell them that if your Medi-Cal stays open, you still have Medi-Cal.\u201d<\/p>\n\n\n\n Sometimes, Campos has to do deeper problem solving. At the beginning of the year, she said some of her undocumented patients were automatically switched from the full-scope Medi-Cal plan into Emergency Medi-Cal. When patients visited MNHC\u2019s enrollment office because their Medi-Cal was inactive, Campos and other enrollment navigators called the offices and sorted out the situation, which ended up being a reversible glitch. <\/p>\n\n\n\n Staff from city-run and nonprofit clinics are also increasingly focused on deadline awareness. They go through patient lists and call them to remind them of their upcoming renewal dates. And when hard-to-reach patients attend the clinic to seek a service, health care specialists make sure to offer reenrollment support. <\/p>\n\n\n\n \u201cThe big push has been impactful,\u201d said Johanna Liu, President of the San Francisco Community Clinic Consortium, which has organized outreach workshops for healthcare workers. \u201cWhen we looked at projected versus actual numbers [of people losing status] folks that wanted to stay on have been able to stay on.\u201d <\/p>\n\n\n\n Still, healthcare workers say they\u2019re encountering more immigrants who understand the re-enrollment process, but aren\u2019t sure if they want to keep their Medi-Cal. <\/p>\n\n\n\n \u201cIt was hard for us to understand these changes,\u201d said Maria Sanchez, a promotora with MNHC. \u201cAnd it\u2019s twice as hard for the community because of fear. People are worried about the government having access to the data they share.\u201d<\/p>\n\n\n\n Last summer, the Centers for Medicare and Medicaid Services (CMS) signed an agreement with U.S. Immigrations and Customs Enforcement (ICE) that let immigration officials access Medi-Cal enrollees\u2019 private information. <\/p>\n\n\n\n Since news of the agreement broke in late July<\/a>, the number of immigrant San Franciscans enrolled in Medi-Cal through its expansion program has dropped every month: from 32,625 in July to 30,935 in December.<\/p>\n\n\n\nGetting help with reenrollment<\/strong><\/h2>\n\n\n\n
Fear of sharing data keeps immigrants from getting coverage<\/strong><\/h2>\n\n\n\n