LOS ANGELES, CA — Hundreds of thousands of Californians will have speedier access to health care thanks to a settlement in a seven-year lawsuit requiring California’s Department of Health Care Services to allow eligible Medi-Cal applicants to receive health coverage right away, subject to later verification of their declared income.
The lawsuit, filed in 2014, sought to end the state’s practice of leaving hundreds of thousands of eligible low-‐income applicants to wait for months without the health care they desperately needed. One of the plaintiffs, Frances Rivera, lost her adult son to a treatable condition while he waited for the state to approve his Medi-Cal application. Shortly after he died—and more than six months after he first applied—Rivera received a letter stating her son qualified for Medi-Cal, and that his coverage would apply retroactively.
When the lawsuit was first filed, there was a backlog of more than 350,000 Medi-Cal applicants who had been waiting significantly longer than was allowed under state and federal mandates. Cancer patients were unable to see oncologists. People with heart conditions were unable to see cardiologists. Without access to arthritis medication, one woman had to go on disability because she could no longer walk. Women with high-risk pregnancies went without the critical care they needed to keep themselves and their babies safe.
“People’s lives are in the balance—our clients knew that firsthand,” said Richard Rothschild, Director of Litigation for Western Center.
The settlement, which was finalized on May 10th, ensures applicants who meet eligibility criteria have health coverage as soon as they apply, while verification and processing are being completed.
“This victory is especially important now, with low-income essential workers and their families bearing the brunt of the pandemic’s health burdens,” said Lynn Kersey, Executive Director of Maternal and Child Health Access, whose organization was a plaintiff in the case.
Plaintiffs were represented by Bay Area Legal Aid, Central California Legal Services, Multiforum Advocacy Solutions, Neighborhood Legal Services of Los Angeles County, the National Health Law Program, and Western Center on Law & Poverty.
“Some 84 percent of Medi-Call applicants are in households with low-wage workers whose jobs don’t provide health insurance for them or their children,” said Lucy Quacinella of Multiforum Advocacy Solutions, lead counsel for the plaintiffs. “This settlement will prevent suffering and help address significant racial disparities in health.”
As the pandemic tore through Los Angeles’ low-income neighborhoods, a lack of access to healthcare led to extraordinarily high levels of serious illness and death—much higher than in wealthier areas.
“Medi-Cal is supposed to be the great healthcare equalizer,” said Neighborhood Legal Services’ Jackie Dai. “This settlement moves us a little closer to that promise.”
The mission of Bay Area Legal Aid is to provide meaningful access to the civil justice system through quality legal assistance regardless of a client’s location, language or disability.
Central California Legal Services (CCLS), established in 1966, provides free civil legal services to eligible low-income residents in Fresno, Tulare, Merced, Kings, Tuolumne, and Mariposa Counties. In partnership with the statewide Health Consumer Alliance, CCLS also serves Madera, San Luis Obispo, Stanislaus, Monterey and San Benito County residents with their healthcare access concerns. CCLS seeks to advance justice through community education and legal service. We endeavor to empower low-income communities to fight social injustice and assert their rights as individuals, groups, and communities. We commit to doing high-quality work promoting systemic change while serving individual clients with respect and compassion.
Lucy Quacinella is an attorney in private practice and the Principal of Multiforum Advocacy Solutions. In addition to impact litigation on health care issues, MAS provides research, analysis, and technical assistance to community-based organizations and assists with legislative and administrative advocacy. Through the Fulbright program, she has collaborated with local human rights advocates in Namibia, Rwanda, and Italy.
Neighborhood Legal Services of Los Angeles County (NLSLA) is a steadfast advocate for individuals, families, and communities throughout Los Angeles County. Each year NLSLA provides free assistance to more than 100,000 people through innovative projects that address the most critical needs of people living in poverty. Through a combination of individual representation, high impact litigation and public policy advocacy, NLSLA combats the immediate and long-lasting effects of poverty and expands access to health, opportunity, and justice in Los Angeles’ diverse neighborhoods.
The National Health Law Program, founded in 1969, protects and advances health rights of low-income and underserved individuals and families. We advocate, educate, and litigate at the federal and state levels to advance health and civil rights in the U.S.
Western Center on Law & Poverty fights for justice and system-wide change to secure housing, health care, racial justice and a strong safety net for Californians with low income. Western Center attains real-world, policy solutions for clients through litigation, legislative and policy advocacy, and technical assistance and legal support for the state’s legal aid programs. Western Center is California’s oldest and largest legal services support center.