It has been a painful lesson for both Covered California and consumers to learn that county Medi-Cal eligibility workers can easily go into a consumer’s account and make changes they deem appropriate. Unfortunately, one Orange County Medi-Cal eligibility worker not only made his necessary changes to the consumer’s account, he also corrupted some information within the Covered California enrollment system. Because Medi-Cal puts a soft pause on the consumer’s account when one of the household members is eligible for Medi-Cal, only the county Medi-Cal worker can correct the wrong mailing address they created and reverse the Covered California consumer’s negative declaration of interest in subsidized health insurance.
Medi-Cal enters corrupt data into Covered California account
Some of the most complicated Covered California cases involved mixed households where some family members qualify for private health insurance with the tax credit subsidy and other household members are Medi-Cal eligible. Because the Medi-Cal SAWS (Statewide Welfare System) computer program is separate from Covered California, it is not uncommon for county eligibility workers to access a consumer’s Covered California account to confirm data. What has always been offensive and unacceptable is that these county eligibility workers make changes without notice or permission to the consumer’s account. (See also: Mysterious Medi-Cal workers change Covered California accounts)
No permission given to Orange County Medi-Cal to make changes
And if the surreptitious data changes weren’t offensive enough, some of these county dumplings manage to corrupt other data within the account. I innocently learned that the address of one of my clients was incomplete in the Covered California system when a Thank You postcard I had sent was returned to me with an undeliverable address. Subsequently, the client told me the correct apartment number. I went into her Covered California account only to discover that I could not change the address because someone had changed her condition of wanting health insurance from YES to NO.
Wrong mailing address prevented notice to the consumer
Upon further review, the consumer’s mailing address had also been changed from the correct PO Box to the incorrect physical mailing address, sans apartment number. And who had done this dastardly deed? An Orange County Medi-Cal eligibility worker. The client wasn’t aware of the corrupted data and address because the letter notifying her of changes to her dependents Medi-Cal status had the wrong address on it, courtesy of the Orange County eligibility worker.
Consumer must waste time fixing Medi-Cal mistakes
The only way this mess can be corrected is for the consumer to make a call to the Orange County Medi-Cal office and talk with the eligibility worker who has corrupted the information. As her agent, I can’t call on her behalf to Medi-Cal. Covered California can’t request a correction because Medi-Cal has supremacy over Covered California.
Will Medi-Cal mistake come back to haunt the taxpayer?
Fortunately, my client’s private health insurance with the subsidy has not been discontinued over the data errors thus far. But no changes to the account can be made and the consumer can’t get information from Covered California because the mailing address is wrong. It is anybody’s guess if having the condition of wanting health insurance with the subsidy be changed from YES to NO will impact the 1095-A and reconciling her tax credits with the IRS. So far, Medi-Cal hasn’t really been too concerned with the nightmare’s they generate for taxpayers as a result of their own blunders.