NLSLA Sues CA for Putting Lives at Risk by Leaving Hundreds of Thousands in Medi-Cal Limbo
Frances Rivera knew there was something wrong with her son’s heart. The Visalia resident, 68, watched for years as her adult son Robert suffered from an array of conditions that, under the supervision of a primary care physician, would have raised a series of red flags. But Robert, who worked a low-wage job, could not pay for insurance. And Rivera grew accustomed to driving him to the emergency room when the pain became unbearable.
“It’s not easy watching someone you love go through this, and there’s nothing you can do,” Mrs. Rivera said. “I just want to cry when I think about all the times we said ‘He has this problem,’ and nobody did anything.”
That’s why the family was encouraged when, after Robert applied for a subsidized plan under Covered California, he was informed he might qualify for no-cost Medi-Cal instead. Robert was told his application would be forwarded to his county’s Medi-Cal office, and was advised to wait to hear back on his status. He died five months later from a pulmonary embolism—still waiting to hear back from the state.
Two months after her son died, Rivera received a letter stating Robert qualified for Medi-Cal, and that his coverage would apply retroactively.
“It’s not just my son, it’s a lot of people who do not hear soon enough that they can get help, and they’re losing time,” Rivera said. “They’re losing precious time.”
Rivera is a plaintiff in a lawsuit filed Wednesday, September 17 in Alameda Superior Court accusing the State of California of leaving hundreds of thousands of low-income applicants to wait for months without the healthcare they desperately need and lawfully deserve. Applicants—including low-income children, pregnant women, people with disabilities, and even those with life threatening illnesses—go without critical care while they wait for the state to process and approve their Medi-Cal applications. Some applicants in the backlog have been awaiting an answer from the state since the end of 2013—far longer than the 45-day time limit required by law.
The lawsuit was brought by a coalition of legal services organizations and community healthcare advocates, including Neighborhood Legal Services, Bay Area Legal Aid, Central California Legal Services, Multiforum Advocacy Solutions, National Health Law Program, and Western Center on Law & Poverty.
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