united-states california medical health-insurance
Do high-asset / low-income people qualify for free medical care in California?
<p>Can people with low incomes qualify for free medical care (Medi-Cal) in California regardless of their liquid assets?</p>
<p>A document on the Department of Health Care Services site (<a href="https://www.dhcs.ca.gov/formsandpubs/forms/Forms/MC%20Information%20Notices/MC007ENG(0414).pdf" rel="nofollow noreferrer">pdf</a>) notes off-hand:</p>
<blockquote>
<p>Note: Medi-Cal disregards property for individuals whose eligibility is determined utilizing your Modified Adjusted Gross Income (MAGI).</p>
</blockquote>
<p>But on the other hand, <a href="https://cahealthadvocates.org/low-income-help/medi-cal-for-people-with-medicare/" rel="nofollow noreferrer">calhealthadvocates.org</a> says:</p>
<blockquote>
<p>To find out if you qualify for one of Medi-Cal’s programs, look at your countable asset levels. You may have up to $2,000 in assets as an individual or $3,000 in assets as a couple.</p>
</blockquote>
<p>Is there a basis for this policy in law, and do high-asset / low-income people qualify for free medical care in California?</p>

<blockquote>
<p>Can people with low incomes qualify for free medical care (Medi-Cal)
in California regardless of their assets?</p>
</blockquote>
<p>For some programs, but not others. The main exception, discussed below, is the Medicaid expansion component of Obamacare (a.k.a. the Affordable Care Act).</p>
<p>One of the exceptions to the general rule considering property is <a href="https://wclp.org/wp-content/uploads/2016/04/WesternCenter_2016_HCGuide_Chapter2.pdf" rel="nofollow noreferrer">as follows</a>:</p>
<blockquote>
<p>The Affordable Care Act introduced a new methodology – Modified
Adjusted Gross Income (MAGI) – to define a family’s size and count
income in order to determine eligibility for insurance affordability
programs. 42 U.S.C. § 1396a(e)(14).</p>
<p>As a result, household determination and income counting rules are
largely aligned among Medi-Cal, the Medi-Cal Access Program (MCAP, the
low-cost health insurance for moderate income pregnant women), and
Covered California, with some exceptions.</p>
<p>For Medi-Cal, the MAGI rules apply to the following programs:
Expansion Adults (adults aged 19 through 64); Parents and Caretaker
Relatives; Pregnant Women; and Children.</p>
<p>Medi-Cal’s Tuberculosis Program and the Refugee Medical Assistance
program also now use the MAGI income methodology. See Welf. &amp; Inst.
Code 14005.20(b)(2) and ACWD 15-16 (Mar. 20, 2015),
<a href="http://www.dhcs.ca.gov/services/medi-cal/eligibility/Documents/ACWDL2015/ACWDL15-16.pdf" rel="nofollow noreferrer">http://www.dhcs.ca.gov/services/medi-cal/eligibility/Documents/ACWDL2015/ACWDL15-16.pdf</a>.
These programs, however, are not considered MAGI Medi-Cal in the
Medi-Cal hierarchy because they are limited in scope or duration and
should only be used when an individual is not eligible for any other
form of free Medi-Cal.</p>
<p>In general, unless an individual gets Medi-Cal through a linked
program such as SSI or CalWORKs, or due to former foster youth status,
Medi-Cal eligibility is reviewed for the MAGI programs before looking
to the Non-MAGI programs.</p>
</blockquote>
<p>Outside that Obamacare program, someone can have significant assets of types that are exempt from consideration (e.g. in the Medicaid nursing home program), but they cannot qualify regardless of their assets. The exact extent to which assets are disqualifying varies by subprogram, with ordinary Medi-Cal, the nursing home program, and the CHIP program for children, having different requirements.</p>
<p>The key language is &quot;countable asset levels&quot;. This is defined in a combination of state statutes and regulations which in turn are enacted in order to comply with federal Medicaid program requirements.</p>
<p>Only some assets count for purposes of Medi-Cal eligibility. In particular, a personal residence, a single motor vehicle, certain household goods, certain retirement assets, certain cash value in life insurance policies, and investment assets that don't generate current cash income and are impracticable so sell in a timely manner at anything approaching their true value because they are illiquid for some reason or other, don't count. Exactly what does and does not count as a countable asset for purposes of Medi-Cal eligibility is a rather technical and detailed matter because there are some many different kinds of assets out there and the rules address them on a type by type basis. The most common exemptions are set forth <a href="https://www.dhcs.ca.gov/formsandpubs/forms/Forms/MC%20Information%20Notices/MC007ENG(0414).pdf" rel="nofollow noreferrer">here</a>:</p>
<p><a href="https://i.stack.imgur.com/Hs9kn.png" rel="nofollow noreferrer"><img src="https://i.stack.imgur.com/Hs9kn.png" alt="enter image description here" /></a></p>
<p>The main regulations for the Department of Health Services that govern this are found <a href="https://www.dhcs.ca.gov/formsandpubs/laws/Documents/Attachment%202.6-A.pdf" rel="nofollow noreferrer">here</a> and <a href="https://www.dhcs.ca.gov/formsandpubs/laws/Pages/Supplements.aspx" rel="nofollow noreferrer">here</a>. More legal sources are found <a href="https://www.dhcs.ca.gov/formsandpubs/laws/Pages/LawsandRegulations.aspx" rel="nofollow noreferrer">here</a>. These primary sources, alas, aren't organized in a very user friendly way. In part, this is because the Medicaid Rules incorporate by reference (with modifications) the rules for the Aid To Families With Dependent Children (AFDC) and Supplemental Security Income (SSI) rules, rather than restating them with the modifications include in full. So the chart on the form is assembled from a mishmash of state and federal regulations in multiple locations.</p>
<p>I didn't find a chapter and verse citation for a few kinds of non-countable assets but know they exist from continuing education classes and practicing in the area.</p>
