We are living in unprecedented times during a global pandemic. In addition to navigating to a new “normal,” we are experiencing a burden on our healthcare systems like we’ve never experienced before. Every level of government has put into place many improved and even new mechanisms to support our healthcare systems and those that access it. For example, individuals who need to renew their Medi-Cal coverage during this time do not have to submit anything until June and many health services are being offered online or over the phone. However, this current pandemic has exposed the significant gaps and disparities in our systems that were there all along.
Federal agencies such as the Centers for Medicaid and Medicare Services (CMS) have issued guidance on how to best provide care during these times. For California, these guidelines were just the starting point. Over the last two months the Department of Healthcare Services (DHCS) has worked with CMS to CMS requesting flexibilities to be able to adequately provide coverage and services to Medi-Cal beneficiaries and support providers. This has resulted in a flurry of activity to ensure coverage and stability which includes the following:
- Pregnant woman can now provide telephonic authorization for their presumptive eligibility coverage for Medi-Cal
- Medi-Cal coverage and benefits cannot be terminated or decreased for any individual who needs to renew their coverage before June 15
- The Department of Managed Healthcare (DMHC) has asked plans to go one step further and check in with older and at-risk patients to make sure they are able to get additional supports they might need at this time beyond healthcare.
- Covered California has extended their Special Enrollment Period (SEP) until June 30th.
- Telehealth services are now covered and the use of technology in healthcare is becoming more important
- Lastly, ALL COVID-19 related testing, screening, and treatments are covered free of charge through various health coverage programs – regardless of immigration status or income level. In fact, an individual accessing COVID-19 related services will not be deemed a public charge.
I’m proud of the work we’ve done here in California. Time and time again, we lead the country in supporting our communities’ access to and utilization of healthcare. However, despite the progress we have made, it has become even more apparent that there continues to be significant gaps in accessing and utilization. Many of these gaps come from a lack of coordination amongst our various healthcare systems. There is still a struggle to provide culturally and linguistically competent messaging and care to our most vulnerable populations. Our numerous partner organizations share that the disconnect between county systems is greater now than it was prior to the pandemic and the need for a centralized system to effectively communicate updates and available resources at the city, county, and even state level.
There has been so much movement to increase access in such a short amount of time, but I can’t help wondering – why did it take a global pandemic to make healthcare more accessible? If, in a state of emergency, we can allow for certain flexibilities so that people can stay healthy, why couldn’t we have done it before? Can we use some of what has been put in place now, like presumptive eligibility for ALL, and build on that to get closer to universal coverage? How can all of our healthcare systems work together as one to better provide care? These times have shown me that we do in fact have the tools and capacity in place to provide high-quality healthcare coverage to all.
I truly believe this is an important and not-to-be missed opportunity to build off the work under way now in order to expand towards a system for universal healthcare. In order to do this well, we will need to not only recognize where gaps are growing and systems are strained (like in language and cultural accessibility and alignment of government systems), but also learn to anticipate and plan for them in any new healthcare systems infrastructure we build. When it comes to having a more centralized healthcare system, we still have a more to do.
Bhavika Patel, MPH, CPH
Policy and Community Engagement Manager