Assemblymember Roger Dickinson recently introduced AB 2025 to raise the income level of the Aged and Disabled Medi-Cal program (A&D program) to 138% of the federal poverty level (FPL). This change would create consistent income eligibility for different Medi-Cal programs and parity for seniors and people with disabilities. With AB 2025, more people who are already in expanded Medi-Cal can transition to the A&D program when they become eligible for Medicare and be protected from a sudden increase in out-of-pocket costs.
Background – What is the A&D Program?
Begun in 2001, the A&D program provides free, full-scope Medi-Cal to low-income seniors and persons with disabilities. For A&D program enrollees who also have Medicare, the A&D program pays their Medicare Part B premium and Medicare cost-sharing, such as the 20% coinsurance for Medicare Part B services. When this program was created, income eligibility was set at 100% FPL, with added income disregards of $230 and $310 for individuals and couples, respectively. In 2001, the disregards brought the income limit to 133% FPL. But because the income disregards have not been adjusted for cost-of-living increases, the disregards have lost value thus the income eligibility limit is currently at 124% FPL, or $1,188 a month for an individual.
Expanded Medi-Cal & the A&D Program
Under the Affordable Care Act, California expanded Medi-Cal by raising the income limit to 138% of the FPL with no asset test. However, people who are 65 years or older or eligible for Medicare are not eligible for expanded Medi-Cal. Thus, someone who now qualifies for expanded Medi-Cal would lose it when they turn 65 or become eligible for Medicare. They would need to qualify for one of the “traditional” Medi-Cal programs, like the A&D program. Otherwise they would have only Medicare and be responsible for the Medicare out-of-pocket costs. AB 2025 would help more people qualify for the A&D program by raising the income eligibility limit for the A&D program from 124% to 138%, same as for expanded Medi-Cal. Without AB 2025, more people who qualify for expanded Medi-Cal will not qualify for the A&D program when they become eligible for Medicare, and will have significantly higher health care costs including their Part B monthly premium –$104.90 in 2014 – and their Part B 20% coinsurance for outpatient services.
Even if AB 2025 passes, not everyone who qualifies for expanded Medi-Cal will qualify for the A&D program because the A&D program has asset limits, whereas expanded Medi-Cal does not. There are efforts at the federal level to increase the asset limit from $2,000 to $10,000 so that more people can qualify for the A&D program.
Join us in supporting AB 2025
AB 2025 was heard by the Assembly Health Committee on March 25. All Committee members present voted “aye” except one. The bill now goes to the Assembly Appropriations.
Please join us in supporting AB 2025 by contacting your State representative today. Ask her/him to support this important legislation, thus allowing more lower-income seniors and persons with disabilities to transition from expanded Medi-Cal to the A&D program.
See our letter of support for more information.
