Support AB 715 ~ Give Seniors & People with Disabilities Equal Access to Medi-Cal

Support AB 715 ~ Give Seniors & People with Disabilities Equal Access to Medi-Cal

California Health Advocates is one of over 60 organizations that have signed on in support of AB 715, which would raise the income level of the Aged and Disabled Medi-Cal program (A&D program) to 138% of the federal poverty level (FPL), creating a “bright line” of income eligibility. This would allow adults with full Medi-Cal, thanks to the higher Medi-Cal income limits implemented through the Affordable Care Act, to be able to keep their Medi-Cal when they become 65 and eligible for Medicare or are eligible younger than 65 due to a disability. Currently, the Medi-Cal A&D FPL income limits for people 65 and older or younger with a disability are only 123% of the federal poverty level, which means over 20,000 seniors are dropped from necessary coverage just because they are now also eligible for Medicare no longer have access to the higher income limit.


March 20, 2019
The Honorable Jim Wood
Chair, Assembly Health Committee
State Capitol, Room 6005
Sacramento, CA 95814
Re: AB 715 – Cosponsor and Support
Dear Assemblymember Wood,
The Western Center on Law and Poverty, Justice in Aging, and Disability Rights California is proud to cosponsor AB 715, which would raise the income level of the Aged and Disabled Medi-Cal program (A&D program) to 138% FPL, creating a “bright line” of income eligibility. We are joined by the undersigned organizations in support of this bill to create parity between senior and disabled Medi-Cal beneficiaries, and other adult Medi-Cal beneficiaries.
The A&D program is a critical part of the Medi-Cal program that provides free, comprehensive coverage to persons over the age of 65 and those with disabilities while simultaneously allowing them to have a monthly income. The A&D program was enacted in 2000, with an income eligibility standard of 100% FPL plus income disregards of $230 and $310 for individuals and couples, respectively. When the program was established, the income level was equivalent to 133% FPL, the same level as most other adults in Medi-Cal. However, the disregards lose real value every year, with the resulting income standard today at 123%FPL. When a senior has even a small increase in their income that puts them over 123% FPL, they are forced into the Medi-Cal Medically Needy program with a high share of cost.
A share of cost is the difference between a beneficiary’s countable income and the Maintenance Need Income Level (MNIL). The MNIL is a fixed monthly amount that is supposed to be sufficient to cover basic living expenses, such as rent, food, and utilities. The MNIL in California is $600 for an individual and has not changed since it was established in 1989. Anything an individual earns over $600 in a month becomes that individual’s share of cost. So, for example, a 67-year-old beneficiary with a monthly income of $1,300 would have to pay $700 for his or her health care before Medi-Cal begins paying for services. There are no exceptions for preventive care or any other types of services as in other types of health coverage.
As part of the Affordable Care Act, California expanded and streamlined eligibility screenings for most Medi-Cal beneficiaries, generally raising the income threshold to 138% FPL. But due to federal requirements, if the state does not increase the income disregard amounts of the A&D program, those elderly Medi-Cal enrollees will continue to be held to the 123% income threshold. So for individuals who would have, but for their age, qualified for Medi-Cal under the new income methodology, this is an unfair gap into which they fall.
Advocates from around the state have for years attempted to help beneficiaries with high shares of cost. Many A&D Program enrollees suffer from conditions that they cannot afford to treat due to their share of cost. Forced between paying for rent and food or their Medi-Cal share of cost, many seniors forgo needed medical services, which can prompt 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. While millions of Californians are now able to qualify for free services because the income threshold was raised, it is inequitable to require a person to pay hundreds of dollars monthly simply due to their age.
For these reasons, we respectfully request your ‘aye’ vote on AB 715. Please contact Linda Nguy, Policy Advocate, at (916) 282-5117 or at should you have any questions.


Linda Nguy
And on behalf of the undersigned organizations:

AARP California
Alzheimer’s Los Angeles
APLA Health
Arc of California
Asian Americans Advancing Justice | Los Angeles
Asian Pacific Policy and Planning Council
Association of California Caregiver Resource Centers
Bet Tzedek
Blue Shield of California Promise Health Plan
California Advocates for Nursing Home Reform
California Alliance for Retired Americans
California Association for Adult Day Services
California Council of the Blind
California Health Advocates
California IHSS Consumer Alliance
California Long Term Care Ombudsman Association
California Office of the State Long-Term Care Ombudsman
California Partnership
Center for Health Care Rights
Coalition of California Welfare Rights Organizations
Communities Actively Living Independent & Free
Congress of California Seniors
Disability Rights Education and Defense Fund
East Bay Community Law Center
Hand in Hand: The Domestic Employers Network
Health Access California
Huntington Senior Care Network
I Did Something Good Today Foundation
Independent Living Resource Center, Inc
International Institute of Los Angeles
Jewish Family Service of Los Angeles
L.A. Care
Law Foundation of Silicon Valley
LeadingAge California
Legal Aid Society of San Mateo County
Legal Assistance for Seniors
LIFE ElderCare
Little Tokyo Service Center
Los Angeles Aging Advocacy Coalition
Los Angeles LGBT Center
Maternal and Child Health Access
MSSP Site Association
National Health Law Program
Ombudsman Services of Contra Costa and Solano
On Lok
Partners in Care Foundation
Personal Assistance Services Council
Public Interest Law Project
San Fernando Valley Interfaith Council, Inc. (VIC)
SEIU California
Senior Advocates of the Desert
Senior and Disability Action San Francisco
Senior Services Coalition of Alameda County
Shelter Partnership
Silicon Valley Independent Living Center
Skid Row Housing Trust
South Asian Network
St. Barnabas Senior Services
UDW/AFSCME Local 3930
Youth Movement Against Alzheimer’s

Karen Fletcher
Our blogger Karen J. Fletcher is CHA's publications consultant. She provides technical expertise, writing and research on Medicare, health disparities and other health care issues. With a Masters in Public Health from UC Berkeley, she serves in health advocacy as a trainer and consultant. See her current articles.

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