I don’t even know where to start with this outrage. Medi-Cal is so convoluted that it is amazing that anyone ever receives any benefit. It is simply impossible for the average human being to understand a program that provides HEALTH CARE to 14,000,000+ people in California. It is the largest department and budget item in the state. Yet I can tell you with certainty that in the legislature, the body that makes all of this happen, there is not one elected official that understands how it works. Hell, many of the people who work there and at the county level don’t know how it works. At the top of this page is a link to the 2017 All County Welfare Director Letters (ACWDL). I want you to pay special attention to letter 17-25. That means it was the 25th letter of 2017. These are administrative “letters” from the state to the county welfare directors. They are not law, or regulations, but letters. They are not from lawmakers. They are from one bureaucrat to another. Yet they determine the fates of millions of people.
In the next few weeks I will be talking about many of these, but for today, just 17-25. Now I don’t remember precisely when the Affordable Care Act (Obamacare) passed, but it was about 7-8 years ago. This letter is just now getting around to implementing a law passed YEARS ago. The state is famous for this. They just ignore federal law until they have the time to get around to it.
Here is why this is important. There is a Medi-Cal program called IHSS. It is a home-based program designed to help pay for care to the frail elderly and the disabled. It pays for a caregiver to come to the home and help. I think this is a very important program. Until the ACA, in order to qualify for this program, a person could only have $2,000 in cash and about $1,000 per month in income. Very few people qualified. Even if married, the family was limited to these amounts. So if the couple had $40,000 in cash and $2,500 in income they could not obtain the benefit to help pay for the ill spouse. The ACA changed all that. Now a couple could keep the same amounts, about $120,000 in cash and $3,000 per month and qualify for IHSS. This is a HUGE game change.
So, good, you say. So what is the outrage Bob? It has taken the state over 5 years to finally approve and implement the changes in California. I would like to say this is an isolated case, but it is not. It has been happening for 30 years. People are denied health benefits because the bureaucrats could not be bothered. Understand, Medi-Cal has one of the highest percentages of retired annuitants in any department in California. These are people who have retired, are receiving full pensions, and then are re-hired at a very large salary to continue to work at the same desk.
Who cares if the frail and disabled can’t get health benefits? It has always been thus, those making the rules are not impacted or victims of the rules. If you are not outraged you should be. Does you legislator care? Ask him or her why the most vulnerable among us suffer and yet the department they fund does not seem to care.
More to come on this issue. I hope it gets your anger up and directed to the folks under the dome.