The Honorable Rob Bonta
Chair, Assembly Health Committee
State Capitol, Room 6005
Sacramento, CA 95814
Re: Support for AB 763 (Burke)
Dear Assemblymember Bonta:
California Health Advocates supports AB 763 (Burke), which would raise the income level of the Aged and Disabled Medi-Cal program (A&D program) to 138% FPL, the same as the income ceiling for MAGI Medi-Cal, California’s adoption of expanded Medicaid provided by the Affordable Care Act.
California Health Advocates is a not-for-profit organization dedicated to providing quality Medicare and related healthcare coverage information, education and policy advocacy. California Health Advocates supports the work of local Health Insurance Counseling & Advocacy Programs (HICAP) which provide benefits counseling and community education on Medicare and long term care. Medicare beneficiaries of all incomes seek HICAP services, including those with low or limited incomes. Many beneficiaries who also qualify for Medi-Cal (dually eligible or Medi-Medi), as well as those whose incomes are low but do not qualify for Medi-Cal or other services that require Medi-Cal eligibility such as In-Home Supportive Services (IHSS), contact HICAP for assistance with services they need but cannot afford.
The A&D program provides full Medi-Cal benefits to low-income seniors and persons with disabilities. When the program was created in 2001, income eligibility was set at 100% FPL. After adding income disregards of $230 for individuals or $310 for couples, the income “cutoff” was 133% FPL. However, the income “cutoff” has decreased to 123% for 2015. Although the FPL is adjusted each year, the income disregards remain the same. Compared to 2001, fewer seniors and people with disabilities can meet the income requirement to qualify for the A&D program.
There are an increasing number of individuals who qualified for MAGI Medi-Cal but no longer qualify when they become eligible for Medicare. These individuals are screened for “traditional” Medi-Cal programs with income limits lower than for MAGI Medi-Cal and an asset test which is not required for MAGI Medi-Cal. Some, but not all, qualify for the A&D program, and some for one of the Medicare Savings Programs (MSP) which have higher asset limits ($7,280 for individuals and $10,930 for couples) than the A&D program. One MSP, the Qualified Medicare Beneficiary program, pays all Medicare cost-sharing, while two others, the Specified Low Income Medicare Beneficiary and the Qualifying Individual programs, pay only the Medicare Part B premium. Those who qualify for a Medicare Savings Program have higher out-of-pocket costs than those who qualify for the A&D program. There are yet others who would not qualify for the A&D program or any Medicare Savings Program: those whose incomes are between 135% and 138% FPL.
By raising the income level for the A&D program to 138%, AB 763 would allow more beneficiaries to qualify for the A&D program and decrease their out-of-pocket costs. Since many public programs, such as In-Home Supportive Services (IHSS), require Medi-Cal eligibility, AB 763 would reduce beneficiary out-of-pocket costs for medical services as well as other needed services.
Although not everyone who qualifies for expanded Medi-Cal will qualify for the A&D program even if the income limit is raised to 138%, by aligning the income eligibility limit for the A&D program with expanded Medi-Cal’s limit, fewer people will suffer a sudden decrease in benefits and increase in out-of-pocket costs when they become eligible for Medicare.
For the reasons stated above, California Health Advocates supports AB 763 and respectfully asks for your support of this important legislation to allow more lower-income seniors and persons with disabilities to be able to transition from expanded Medi-Cal to the A&D program when they become eligible for Medicare.
Sincerely,
Elaine Wong Eakin
Executive Director
