By Children Now Health Team
September 12, 2022
Top image via iStock from hxyume
As of July 1st, 2022, over 500,000 children, pregnant people, and working adults with disabilities do not need to pay Medi-Cal premiums, zeroing out their payments to $0 per month. This new financial relief was approved by lawmakers as part of the final FY 2022-23 state budget and does not require any action by families.
Why are we so excited about this change and what should people know about zeroing out of Medi-Cal premiums?
Nearly one in three California households do not earn sufficient income to meet their basic needs, and wages simply have not kept pace with the real cost of living. Monthly Medi-Cal premium payments placed an economic burden on families and contributed to barriers in access to care and breaks in coverage for eligible individuals. Zeroing out Medi-Cal premiums provides overdue economic relief to hundreds of thousands of Californians.
What happens next?
- Individuals should be on the lookout for notices. Notices and frequently asked questions (FAQ) documents on the zeroing of premiums were sent out by mail beginning in July 2022. No response is required by enrollees and no action needs to be taken for an individual’s premiums to be zeroed out.
- All outstanding unpaid premiums are being eliminated and refunds will be issued to individuals with credits. During the public health emergency (PHE), some individuals and families requested a waiver to stop their monthly payments, and some families requested credits for payments made dating back to the start of the waiver program. All outstanding premium payments/balances will be eliminated and individuals who requested credits will receive a refund. NOTE: Since the COVID-19 PHE is still in effect, families and individuals can still request a waiver which will provide a refund for payments made during the PHE.
- Where can families get more information and assistance? Please see and share this information sheet (oprime aquí para información en español) via social media, newsletters and mailings, etc. with your networks and families you serve.
This incredible win for Californians would not have been possible without the collective efforts of members of The Children’s Movement (TCM), Children Now, Pro-Kid leaders and policymakers. Promoting policies that help children and families thrive requires sustained engagement, research, and advocacy from a broad range of stakeholders.
A Timeline of Collective Advocacy Efforts to Zero Out Premiums in Medi-Cal
Prior to March 2020
Over 500,000 children, pregnant people, and working disabled adults are required to pay monthly Medi-Cal premiums
March 2020 – COVID 19 Premium Waiver Program launched providing economic reflief for families by waiving monthly premium payments. Individuals required to sign up to waive premiums.
Ongoing – Health stakeholders advocate to DHCS to automatically grant premium waivers to all eligible individuals (i.e., remove the opt-in requirement) and request data on waivers granted.
Ongoing – Administrative advocacy to automatically provide premium waivers to all eligible individuals during the PHE and eliminate premiums alltogether after the end of the PHE.
September 2021 – Children Now research shows evidence of the benefits of eliminating Medi-Cal premiums to promote children’s health.
November 2021 – More than 450 Movement members sign on to a letter urging Governor Newsom to eliminate Medi-Cal premiums for over 500,000 children and pregnant people.
January 2022 – Governor Newsom includes zeroing out of Medi-Cal premiums in his proposed budget.
February 2022 – Assemblymember Arambula introduces AB 1995 to show legislative interest and support for complete elimination of Medi-Cal premiums.
June 2022 – Final FY 2022-2023 state budget zeros out monthly Medi-Cal premiums for over 500,000 Californians!
July 2022 and beyond – Starting July 1st, Medi-Cal premiums zeroed out. Yearly monitoring required to ensure premiums are not reinsteted in the future.
As we celebrate this win for California’s kids and families, we must also remain vigilant to ensure monthly premiums are not reinstated in the future, particularly during economic downturns when kids, pregnant people, and working adults with disabilities are most impacted by economic hardship. We look forward to working with The Children’s Movement (TCM) members and Pro-Kid supporters to continue protecting children’s health coverage and access.