California Health Advocates, along with 70 other advocacy organizations statewide, submitted a letter to Governor Newsom requesting that implementation of Medi-Cal Share of Cost reform be included in his January 2024-25 Budget Proposal. This would make the reform effective in January 2025, subject to budget appropriation. We urge the timely implementation of this reform beginning January 1, 2025 in order to end the severe financial burden the existing program has on many older adults and people with disabilities. Once implemented, California would join New York state in leading the nation in making Medicaid more affordable for low-income older adults and people with disabilities.
The current Medi-Cal Share of Cost program forces low-income individuals to live at the maintenance need level in exchange for Medi-Cal services. The current Medi-Cal maintenance need level is $600 a month for a single person, equivalent to 49% of the federal poverty level. California’s maintenance need level has not increased since 1989. If an individual’s income is over $600 a month, they are responsible for paying the paying the remaining income towards their health care each month before they are eligible for Medi-Cal. For example, if an individual’s countable income is $1800 a month, their monthly Medi-Cal share of cost is $1200 and they have $600 left to pay their rent, food, utilities, clothing and all other expenses each month. It is impossible to live off of $600 a month.
This level of cost sharing is irreconcilable with other recent efforts in California to make health care affordable and equitable, including efforts to expand access to Medi-Cal and lower the cost of Covered California plans – which is why we are grateful that the Administration and Legislature agreed to raise the maintenance need income level to 138% FPL in the FY 2022-23 budget, beginning January 1, 2025. Implementing this reform on time would mean that older adults and people with disabilities will no longer have to make the impossible choice of paying for their health care or making rent and having food on the table.