Thirty-year-old Medi-Cal income limit leaves some seniors without needed care

Aging advocates say older adults tend to live on fixed incomes but are sometimes subject to rules that haven’t kept up with the current cost of living.

Aging and health advocates are now asking legislators and the governor’s office to allow Medi-Cal recipients who need to pay a share of cost to keep more of their income. Assembly Bill 1900 by Assemblymember Dr. Joaquin Arambula, a Fresno Democrat, proposes to raise the monthly limit from $600 for an individual, which is about 55% of the federal poverty level, to $1,562, or 138% of the federal poverty level.

This adjustment would require federal approval, according to the Department of Health Care Services, which oversees the Medi-Cal program.

Arambula’s bill made it out of the Assembly last week and is now before the Senate. “This is simply a matter of fairness for Californians who are struggling to make ends meet and need access to health care,” Arambula said about his bill in the Assembly Health Committee hearing earlier this year.

Linda Nguy, a policy advocate with the Western Center on Law and Poverty, said it would be difficult to pass the bill if funding for it isn’t included in this year’s state budget. Funding for this proposal was not included in the governor’s May revision of the budget.

However, the version of the budget released Wednesday by the Legislature’s Democratic leaders allocates $31 million to reduce the share of cost for this population. The Legislature and Gov. Gavin Newsom must now come together and hammer out a final budget.

The Legislative Analyst’s Office has estimated that this proposal would cost anywhere between $53 million and $151 million, of which half would be paid for by the state and the other half through federal funds. Without that funding, Arambula’s bill would likely get stuck in the Senate’s fiscal committee, Nguy said.

At least nine other states and the District of Columbia allow people who pay a share of cost for Medi-Cal (Medicaid in other states) to keep a higher amount for personal use than California does, according to the Kaiser Family Foundation.

“It’s so unfair,” said Naty Chavira, a teacher in the Los Angeles area whose parents, Jose and Alicia Chavira, are struggling to afford expensive medication and in-home assistance. “Do you know how hard my dad worked? He paid his taxes, he’s a good citizen, and here he is today in survival mode. I know that his finances are taking a toll on his health.”

Jose, 77, a former welder, has been struggling with a number of health issues and symptoms — diabetes, depression and vertigo, among others. He has spent most of his retirement caring for his wife, Alicia, 78, a former housewife who raised six kids and was diagnosed with Alzheimer’s disease a few years back. But now his health is deteriorating too.

Naty would like her parents to get some in-home assistance and for her dad to get the hearing aids he needs, but Medicare won’t pay for those expenses, so she helped them apply for Medi-Cal. However, in order to get that coverage, the couple would get to keep only $934 of their $2,600 monthly Social Security income.

When you take $500 away for bills, they’d get to keep $400 for their food and medication. “It’s insane,” Chavira said.

CalMatters COVID and health care coverage is supported by grants from the Blue Shield of California Foundation, the California Health Care Foundation and the California Wellness Foundation.

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