Plain English Breakdown
The bill relies on an appropriation in the annual Budget Act for implementation.
Medi-Cal Redeterminations and Work or Community Engagement
This bill updates Medi-Cal rules so that adults aged 19 to 64 with low income must check their eligibility every six months instead of once a year, and it prepares for work or community engagement requirements starting in 2027.
What This Bill Does
- Changes the rule for checking eligibility from once a year to once every six months for adults aged 19 to 64 with income up to 138% of the federal poverty level.
- Allows people to return renewal forms by phone, online, or other electronic methods instead of only in person or by mail.
- Requires counties to accept specific types of signatures on these new digital and telephone forms.
- States that the state department should implement work requirements with as few data requests from applicants as possible.
- Orders counties to check managed care plan records before asking beneficiaries directly if they meet work or community engagement rules.
Who It Names or Affects
- Medi-Cal adults between ages 19 and 64 who earn up to 138% of the federal poverty level.
- County agencies that handle Medi-Cal eligibility checks and renewals.
- The State Department of Health Care Services, which must create new rules by July 2028.
Terms To Know
- Redetermination
- A process where the county checks if a person still meets the rules to keep their Medi-Cal coverage.
- Medicaid expansion adults
- People aged 19 to 64 with income up to 138% of the federal poverty level who qualify for Medicaid under existing law.
- Community engagement
- Activities like working, volunteering, or going to school that some Medi-Cal adults may need to do to keep their coverage starting in 2027.
Limits and Unknowns
- The work and community engagement rules only start if the state gets money approved in the annual Budget Act.
- These changes will not happen until the Director of Health Care Services confirms that computer systems are ready to handle them.
- This bill stays active only as long as the federal law from July 2025 remains in effect.