At several Covered California public enrollment events I have participated in there have been Certified Agents who have declined to help individuals and families who potentially qualified for Medi-Cal. The qualification is based on the household income. The refusal to assist an applicant because they might qualify for Medi-Cal is a form of economic discrimination that shouldn’t be tolerated.
Myth: agents can’t assist Californians applying for Medi-Cal
Several Certified Agents I have talked to at the enrollment events organized by local community groups are under the impression that they can’t enroll Medi-Cal applicants and others won’t because there is no money associated with Medi-Cal enrollment. Usually this misinformation is passed down by their managers at the general agency they are affiliated with. The sole purpose for a general agency to instruct their agents to refuse assistance to low and moderate income families is money. Medi-Cal doesn’t pay a monthly fee or commission like insurance companies and health plans.
Income discrimination shows its ugly face
This discriminatory practice is made even worse by the fact that the agents don’t even let the Covered California CalHEERS enrollment system determine Medi-Cal eligibility. The agents just make an assumption based on questioning the prospective applicant’s income amounts. This sort of assumption is one step removed from assuming the character of a person based on their skin color, race, ethnicity or sexual orientation. When an agent tells someone they have to visit the “Medi-Cal Table”, I hear, “go sit in the back of the bus.” Bulls–t on that noise.
“No Wrong Door” applies to agents
Covered California professes to have a “No Wrong Door” approach when it comes to helping people enroll in either health plans that are eligible for premium assistance or expanded Medi-Cal. Some agents and general agencies have decided to slam the door on some California’s based on their income. They should append their Covered California business cards and table signs to read “I’ll help you if you make me money.” The refusal of an agent to help any Californian after the agent has been certified and agreed to represent all health plans fairly is another instance of placing profits before people.
Ignorance is no excuse
I’ve heard the excuse that some agents don’t know how to enroll people in Medi-Cal therefore they can’t do it. No agent or certified Enrollment Counselor enrolls anyone in Medi-Cal. All we do is help determine eligibility. The CalHEERS system tells us if the adults and children are Medi-Cal eligible. Covered California helps expedite the process by allowing people to upload supporting documents before the case is transferred to the respective county for final approval and actual enrollment in Medi-Cal. See “Uploading documents to Covered California”
Medi-Cal enrollments don’t pay
Two adults making minimum wage of $8 an hour, working full-time is equivalent to $30,720 per year. If those adults have two children, the whole family is Medi-Cal eligible. That same family of four can have a Modified Adjusted Gross Income of $58,000 and the children would still qualify for Medi-Cal and the adults would receive premium assistance. Do the agents that refuse to help Medi-Cal individuals also refuse to help families when the children are eligible for Medi-Cal kids? No, because at least the adults represent a commission or fee for the discriminating agent.
Profits before people
Low and moderate wage families are the very people the Affordable Care Act was designed to help. The whole purpose of Covered California is to extend affordable health insurance to those who most need it. These men and women who are eligible for Medi-Cal are every bit as deserving of an agent’s assistance as a family that qualifies for premium assistance. The goal is help everyone stay healthy, productive and sustainable. If an agent can’t support that goal he or she should relinquish their Covered California certification and stop participating in a government program that is putting money in their pockets.
How much are you worth to me?
Covered California displays on their home page that they are the destination for affordable, quality health care, including Medi-Cal. Certified agents need to assist anyone who comes to them for enrollment help whether it is at a public event or in their office. The refusal to help anyone based on their income and likelihood of enrollment in Medi-Cal is a betrayal of not only the signed agent agreement but also an embrace of discriminatory practices that endorse the concept that a person’s value is based on their net worth.
Count me out of discrimination and events
I will happily attend any public enrollment event and assist anyone applying either for Medi-Cal or a health plan with or without premium assistance. However, hence forth, I will not attend any event where Certified Agents are allowed to discriminate against people based on their income and Medi-Cal eligibility. Further, if anyone is refused assistance from an agent because they might be Medi-Cal, please do us all a favor and report that agent to Covered California. Income discrimination practiced by Certified Agents needs to stop.
