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Medi-Cal reform could have lasting effect on Black health


What do these reforms mean?

With Medi-Cal currently in the middle of its unwinding period and trying to get people back insured through their program, experts have noticed a lack of Black applicants for the new year.  Dr. Monica Soni, the newly appointed chief medical officer of Covered California, has some answers as to why there is low participation from both communities and what solution Medi-Cal is hoping for. 

Medi-Cal was already making moves with the news of My Health LA closing. Medi-Cal expanded its benefits to provide coverage to people aged 17-25 regardless of income and citizenship status. " We have been moving in this direction of expanded coverage for years now, starting with our elders and now moving to a broad net of coverage for all Californians," Soni said as she spoke about the necessary moves Medi-Cal has made to help their clients. " I was excited to see how easy Medi-Cal made it for My Health LA participants to switch insurances and still have the same kind of coverage and providers for some while making it relatively easy for others to find new providers that take their insurance." 

Soni's knowledge of the Medi-Cal system comes from her time as the director of Specialty Care for the Los Angeles County Department of Health Services and associate chief medical officer at New Century Health.  During her time at the previous two positions, she experienced the unwinding of Medi-Cal last year and helped get people insured. "During this time, we had to go through the process of verifying people's information like their address and phone number, and if any changed over the last few years, we kinda had to track them down to let them know about the unwinding and to reapply for benefits," Soni said as she emphasized that front line workers had to comb through 13 million applicants getting people reinsured for 2024. 

Soni acknowledges that the Affordable Health Care Act has increased the level of Black participants, but the numbers are still low. According to DCHS reports, in Nov. of 2023, there were 68,453 new applicants, and only 1,835 were Black enrollments. Of the 358,689 total applicants, only 25,872, or 9.5% were Black applicants awaiting redetermination, with only 19,420 applicants resubmitting their applications. Only 13,492 applicants continued their coverage with Medi-Cal, which is a disappointing number. 

" It starts with trust, and the medical community has not earned the trust of the Black community after its extensive history of experts performed, disfranchisement, and the denial of access to medical care that has created this dynamic," Soni said as she talked about the next steps for both communities to get on a positive footing. "The system is changing, and you can see by looking at me and other Black people in the healthcare field, but the Black community also has to be open to getting medical help because the alternative is counterproductive."