California's health insurance marketplace, Covered California, has fixed a computer issue that automatically moved certain women out of marketplace coverage and into Medicaid coverage without their knowledge or consent, Kaiser Health News reports.
Policy change causes coverage disruptions
Typically, household income determines whether an enrollee is directed to enroll in Medi-Cal -- California's Medicaid program -- or a Covered California marketplace plan. A policy change that took effect in October 2015 called for women who are pregnant with incomes between 138 percent and 213 percent of the federal poverty level to be directed into Medi-Cal coverage automatically when they enroll.
However, the policy allows pregnant women in that income range who have a Covered California plan at the start of pregnancy to keep that plan. Some women may wish to keep their current plan in order to access their preferred providers.
When the policy took effect, Covered California's computer system had not been updated to allow women to keep their marketplace plans. As a result, between October 2015 and May 2016, about 2,000 pregnant women lost their marketplace plans and were automatically moved into Medi-Cal. The coverage disruption caused women to lose their established providers and miss prenatal care appointments, according to KHN.
In April, California's congressional delegation sent a letter to Covered California, calling for the issue to be resolved promptly. Covered California began calling women who were affected by the issue in May.
Issue fixed
The Covered California computer system was fixed as of Sept. 26, KHN reports. Now, pregnant women in the affected income range will be able to go online and choose whether to keep their marketplace plan or move to Medi-Cal.
Lynn Kersey -- executive director of Maternal and Child Health Access, an advocacy group based in Los Angeles County -- called the news "a relief." She said, "The important thing is that these women have a choice" (Bazar, Kaiser Health News, 10/5).
