Lawsuit Says CA Puts Lives at Risk by Leaving Hundreds of Thousands in Medi-Cal Limbo

Lawsuit Says CA Puts Lives at Risk by Leaving Hundreds of Thousands in Medi-Cal Limbo

FRESNO, CA—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.  

“There are still 350,000 applicants in the backlog. These are not just numbers. These are real people, and they are suffering,” said San Francisco attorney Lucy Quacinella. “The state has decided it’s OK to leave them in limbo, allowing their health to deteriorate as they wait desperately for word about their Medi-Cal applications. It’s not OK—it’s illegal.”  

The lawsuit was brought by a coalition of legal services organizations and community healthcare advocates, including Bay Area Legal Aid, Central California Legal Services, Multiforum Advocacy Solutions, National Health Law Program, Neighborhood Legal Services of Los Angeles County, and Western Center on Law & Poverty.

Organizational Information and Press Contacts    

Multiforum Advocacy Solutions   

Contact Lucy Quacinella, attorney: (415) 407-5386  
Multiforum Advocacy Solutions, founded by Lucy Quacinella, is a private firm based in San Francisco that specializes in health and other public benefits programs and related international human rights.   

Central California Legal Services
Contact Gillian Sonnad, attorney: (559) 570-1238  
Central California Legal Services is a non-profit law firm. We provide free legal assistance to low income families and individuals in the following counties: Fresno, Kings, Mariposa, Merced, Tulare, and Tuolumne.   

Neighborhood Legal Services of Los Angeles County  
Contact Katie Murphy, attorney: (323) 899-6611  
Neighborhood Legal Services of Los Angeles County (NLSLA) is one of California’s most prominent public interest law firms. Each year NLSLA provides free assistance to more than 80,000 individuals and families through programs that expanded access to justice for the poor and address the most critical needs of Los Angeles’ poverty communities.

Western Center on Law and Poverty  
Contact Jen Flory, attorney: (916) 282-5141  
Since 1967, Western Center on Law and Poverty has led the fight  in California’s courts, counties and capital to secure housing, healthcare and a secure safety–net for low–income children, women and men. Western Center’s attorneys and advocates are the impact litigation lawyers for the poor and their voice in Sacramento.

Bay Area Legal Aid  
Contact Michael Keys, attorney: (415) 354-6339    
Bay Legal’s mission is to provide meaningful access to the civil justice system through quality legal assistance regardless of a client’s location, language or disability.

National Health Law Program  
Contact Kimberly Lewis, attorney: (310) 204-6010, ext. 108   
Founded in 1969, the National Health Law Program (NHeLP) protects and advances the health rights of low-income and underserved individuals and families. The oldest nonprofit of its kind, NHeLP advocates, educates and litigates at the federal and state levels.

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