More than 13,000 Ventura County residents have dropped their Medi-Cal health insurance since October in a decline officials are convinced will continue and possibly snowball.
Leaders of the Gold Coast Health Plan, which administers Medi-Cal in Ventura County, said they’re investigating the exact reasons for their falling membership numbers. But they pointed fingers at immigration enforcement fear, renewal and enrollment changes as well as coming provisions of President Donald Trump’s “big beautiful bill.”
Dr. Felix Nuñez, CEO of Gold Coast Health Plan, said 10,000 more people could drop out of the program by the end of year as part of a trend being felt statewide. He said the loss of insurance will mean sick people won’t get treatment and will inflict financial wounds on every health system in the county.
“We can’t stop this,” Nuñez said, adding that the goal is to address misinformation that may be pushing people out of the program and slow the enrollment slide. “Will it be really, really bad or can we make it less bad?”
Medi-Cal is the insurance program funded by state and federal government for low-income residents. In Ventura County, more than 227,000 people are covered by the program — about 1 in 4 residents.
Enrollment in the Gold Coast had been rising. The decline, now nearly 6% of total enrollment, emerged shortly after the July passage of Trump’s budget reconciliation package – the “big beautiful bill.” The law includes about $900 billion less in spending over 10 years to the nationwide Medicaid health insurance system that includes Medi-Cal in California.
The legislation is designed to save money by targeting fraud and waste in Medicaid. Changes include adding more frequent eligibility checks and other requirements needed to keep coverage. The bill brings cost-sharing provisions for some adults and work-reporting rules that mean many recipients will have to hold jobs, go to school or do volunteer work in order to keep insurance.
The Congressional Budget Office projected the law will increase the number of uninsured people in 2034 by 10 million.
‘This is deliberate’
But the biggest changes have not yet begun with provisions like the work rules and increased eligibility checks set to start in January. Nuñez said the legislation has fueled confusion about timelines and eligibility that may be causing people to drop coverage when they’re still eligible.
“That to me is not an accident. This is deliberate,” he said, contending the federal legislation was designed to create fear that pushes people out of Medi-Cal to cut federal costs. “You don’t get $900 billion unless you kick off people who are fully eligible.”
Others contend the falling enrollment is pushed in part by concern and confusion over a state enrollment change that blocks new enrollments for undocumented people ages 19 and older though emergency and pregnancy care is still available. The freeze started in January and does not affect people who are already in the program.
Yvonne Gutierrez is director of the El Concilio Family Services nonprofit in Oxnard that does community outreach for Gold Coast. She said factors behind falling membership likely include changes in renewal requirements, including the provision coming in January that means many people will have to renew every six months.
“There’s a lot of things in play here. I don’t think you can point to one thing,” she said of declining enrollment.
Immigration fear plays a role
Nuñez, Gutierrez and others said people are afraid that signing up for Medi-Cal creates a paper trail that will be used to find undocumented people in the ongoing immigration enforcement crackdown. Court rulings allow the federal agency that runs Medicaid to share data with the Department of Homeland Security though the legal battle over the issue continues in California.
They worry too people here legally are dropping Medi-Cal to protect family members who are undocumented.
Gold Coast Health Plan data shows immigration issues appear to be driving some dropped memberships but not as many as leaders expected.
Financial records show about 3,000 of the people who dropped Medi-Cal coverage from October to March were listed as having “unsatisfactory immigration” status. It’s a group that includes undocumented people but also includes others such as lawfully permanent residents who have been in the country less than five years.
More than twice as many with immigration status deemed “satisfactory” — about 7,500 people — dropped Medi-Cal coverage.
Many of the people who are dropping out may think they are no longer eligible for care when they still are, Nuñez said, noting Gold Coast Health Plan and other agencies are trying to stem misinformation.
“If you’re on it, you need to keep it,” he said of coverage.
‘Feel the burn’
The decline in enrollment has emerged in fewer patients in the birthing unit at Ventura County Medical Center but has not yet reached other parts of the system, said Dr. John Fankhauser, agency director. But those hits are coming and the effects could be huge, he said, noting about 65% of the patients in the county-run safety net system are insured through Medi-Cal.
The falling enrollment means less patients and less Medi-Cal revenue, said Jim Corwin, chief financial officer for Community Memorial Health System in Ventura.
“I would say so far it’s not that bad but we’re starting to feel the burn,” he said.
Nuñez said every hospital will feel it. Though hospitals are required by federal law to provide care regardless of coverage, he said the cuts to Medi-Cal coverage will build a barricade to treatment.
“Not having coverage means you’re not going to get care,” he said. “You are shut out.”
Health leaders and others predict the uninsured will seek care only in emergency rooms and only when their health is so dire they have no choice. It means treatment will be less effective and hospital costs will mushroom because of the uncompensated care.
“It’s going to be awful,” Gutierrez said. “They’re not going to see the doctor until it’s an emergency. Preventative care will be out the door.”
Nuñez went further.
“People will die,” he said. “That’s a consequence of it.”
Tom Kisken covers health care and other news for the Ventura County Star. Reach him at tom.kisken@vcstar.com.
SUPPORT LOCAL JOURNALISM: To see more stories like this, subscribe.
This article originally appeared on Ventura County Star: Thousands drop Medi-Cal in Ventura County. Here’s what it means
Reporting by Tom Kisken, Ventura County Star / Ventura County Star
USA TODAY Network via Reuters Connect
