Both the State Assembly and Senate have included a raise to the Medi-Cal Aged & Disabled income limit to end the senior penalty in their final budget. This is great news! This means tens of thousands of older adults and people with disabilities will now have access to free Medi-Cal and be able to access long term services and support (LTSS) without having a $600/month share of cost to meet. We want to ensure this remains in the final budget and stays top of mind to decision makers. Therefore we’re asking you to join us in making calls to leadership or conference committee members (if you live in their district). Below is a fact sheet put together by the Western Center on Law & Poverty, and a list of names and numbers to call. Thank you in advance for your support!
Most adults under 65 are eligible for free Medi-Cal with incomes up to 138% of the Federal Poverty Level (FPL), while most seniors and people with disabilities can only qualify for free Medi-Cal if their incomes are below 122% FPL– the eligibility level for the Medi-Cal Aged and Disabled Program (A&D Program). Once over the A&D income eligibility limit, seniors and people with disabilities are enrolled in Medi-Cal with a share of cost. For many this means they can’t afford to use their Medi-Cal.
The Affordable Care Act and state legislation increased the Medi-Cal income eligibility level for most adults to 138% FPL, but most seniors and people with disabilities with income above 122% FPL (a difference of about $150 per month) have a share of cost.
A share of cost is the difference between a beneficiary’s countable income and the Maintenance Need Income Level (MNIL), or what the state considers to be the base amount of income a person needs to survive on a monthly basis. Since 1989, the MNIL has been steady at $600 per month and any income over that amount becomes that individual’s share of cost. For example, a 65-year-old with a monthly income of $1,300 would have a share of cost of $700. If that same beneficiary was 64, she would be enrolled in free Medi-Cal.
Paying the share of cost creates significant barriers for seniors and people with disabilities who want to live in the community and need access to affordable health care. Forced between paying for rent and food or their Medi-Cal share of cost, many forgo needed medical services, prompting them to move into skilled nursing facilities at a high cost to the state and an even higher personal cost to their own independence and well-being.
Raising the A&D income limit to 138% FPL is the simplest and most cost-effective way to ensure low-income seniors and people with disabilities have equitable access to affordable health care.
Allocate funds to increase the A&D Program income level to 138% FPL, an amount equivalent to other adult Medi-Cal income levels, and adopt language to implement change.
We thank the Assembly and Senate budget committees for approving proposal and urge this action remain in final budget.
I’m calling to thank the [Senator/Assemblymember] for ending the senior penalty by raising the Medi-Cal Aged & Disabled income limit. Both houses took the same action and ask that it remains in the final budget. It is unfair that at age 64 someone could be eligible for free Medi-Cal but with the same income are no longer eligible because of their age or disability status.
People to Call:
Budget Conference Committee Democrats
- Assemblymember Phil Ting (D-San Francisco) — (916) 319-2019
- Assemblymember Kevin McCarty (D-Sacramento) — ( 916) 319-2007
- Assemblymember Shirley Weber (D-San Diego) — (916) 319-2079
- Senator Holly Mitchell (D-Los Angeles) — (916) 651-4030
- Senator Richard Roth (D-Riverside) — (916) 651-4031
- Senator Nancy Skinner (D-Berkeley) — (916) 651-4009
- Assembly Speaker Anthony Rendon (D-Lakewood) — (916) 319-2063
- Senate Pro Tempore Toni Atkins (D-San Diego) — (916) 651-4039