There’s automated efficiency, and then there’s the Brave New World. Writer Nicole Hopkins’s mother, a resident of Washington state, found that out when she used Washington’s health plan exchange website to find a new insurance plan, and was presented with exactly one “option”: Medicaid. Ms. Hopkins mère has always paid for private insurance, and fully intended to continue doing so, even when Obamacare caused her preferred policy to be cancelled. But the new health plan exchange in Washington doesn’t offer her an option to buy insurance. It has simply determined that she will be a Medicaid beneficiary.
If that seems high-handed, consider the report of a California business owner to Tyler Durden at ZeroHedge (emphasis added):
My company, based in California, employs 600. We used to insure about 250 of our employees. The rest opted out. The company paid 50% of their premiums for about $750,000/yr.
Under obamacare, none can opt out without penalty, and the rates are double or triple, depending upon the plan. Our 750k for 250 employees is going to $2 million per year for 600 employees. …
Here is the craziest part. Employees who qualify for mediCAL (the California version of Medic[aid]), which is most of my employees, will automatically be enrolled in the Federal SNAP program. They cannot opt out. They cannot decline. They will be automatically enrolled in the Federal food stamp program based upon their level of Obamacare qualification. Remember, these people work full time, living in a small town in California. They are not seeking assistance. It all seems like a joke. How can this be the new system?
Pelosi, pass the bill to find out what’s in it? Surprise! You’ve annihilated the working class.
Read the whole thing.
SNAP, as most of you know, is the food stamp program. In California, it’s called CalFresh. Many of you will remember the Fox News special done earlier this year on abuse – er, robust use – of the program by a happily and deliberately unemployed 29-year-old surfer in southern California.
But the California employer who emailed Tyler Durden is talking about people who work, who’ve never applied for food stamps and never wanted them. Are they in fact being automatically enrolled in SNAP/CalFresh?
That’s a good question. There has certainly been an urgent push over the last two years by “food policy advocates” in the state to get the application process integrated for all forms of state benefits. Integrating the programs at the application level creates a big database of welfare dependents whose income and other eligibility-related information can be trolled and harvested by the agencies. After all, there are a lot of people who are signed up for one benefit but not for others. This is appalling, from the perspective of policy advocates.
Most of the references I found in policy documents are to using CalFresh enrollment information to fish for new MediCal subscribers, rather than vice versa. (See this 2012 proposal from Blue Shield, for example. For quick reference, right click in the document and do a “Find” on “express lane,” to navigate quickly to specific proposals for using enrollment and eligibility data from one program for another.)
But there is a panting desperation among benefits advocates in California to get more people enrolled in CalFresh. As Assemblyman Raul Bocanegra puts it, eligible Californians’ rate of participation in food stamps is “abysmal.” The editorial he refers to in his letter to the editor has this to say (emphasis added):
The Affordable Care Act offers a once-in-a-generation opportunity for the state to modernize food assistance and add millions of needy people to the CalFresh rolls. As state health officials implement the Affordable Care Act, food policy advocates are urging them to consider integrating CalFresh into those processes as well.
In most cases, people newly eligible for medical coverage under the Affordable Care Act will also be eligible for CalFresh. Applications for both programs ask the same questions. … When someone signs up for health care, can they also automatically sign up for and become eligible for food assistance? Can updates and renewals be transferred between both programs?
[C]hecking a box that sends the health care applicant’s paperwork to the CalFresh program ought to be doable.
State Senator Kevin De Leon certainly thought so, when he proposed SB 970 in April 2012. The intent behind SB 970 looks like precisely what the California businessman’s employees are running into:
Allows individuals to have application information from the single state application for health subsidy programs to be provided to county human service departments to initiate a simultaneous application for the California Work Opportunity and Responsibility to Kids (CalWORKs) and CalFresh programs.
It’s not clear to me that De Leon even had to go to the trouble, considering that this form of integration was already being advocated by food policy activists directly to the California Health Benefit Exchange Board (emphasis in original):
Consumers would seamlessly apply through the portal for first health and then nutrition benefits.
1. Consumer would first fully complete the application for health benefits on the portal.
2. Then, all likely income-eligible consumers would be told that their on-line application for Cal-Fresh nutrition benefits will be submitted automatically, unless they opt-out. …
Senate Bill 970…would have required the California Health Eligibility, Enrollment and Retention System (CalHEERS) to establish a streamlined, single point of access for low-income Californians seeking health benefits to learn about and apply for other state and federal assistance for which they might be eligible. …
I understand that the state CalHEERS online portal has been designed with “Learn More About” links to websites where people can connect to the program and apply online. Additionally a “Refer To” checkbox for healthcare applicants wishing to be referred to the CalFresh and/or CalWORKs programs has been worked into the single state paper application which will be released later this week.
This chain of evidence has a missing link, of course, which is hard documentation of where in the process Californians might be auto-enrolled in CalFresh. I suspect it’s something the 58 counties have different policies on. The counties administer most of the California state programs, including CalFresh and CalWORKs, so actual enrollment is something that happens according to how your county does it. It could be that health exchange customers’ application info is, in fact, being sent to CalFresh in every county, but only some counties are set up to automatically enroll everyone who’s eligible.
Here’s a cheery dispatch, for example, from Del Norte County, just before 1 October:
Fortunately, our county has existing resources that give us a head start in this effort. For example, our county — like all 58 counties in the state — has an integrated eligibility system for enrolling people into MediCal, CalWORKs, CalFresh and other programs.
The “integrated eligibility system” referred to is CalHEERS, also alluded to above by Senator De Leon. It’s correct to say, as suggested by the De Leon letter, that paper applications for health benefits coverage have a referral box that has to be checked for customers who also want to establish eligibility for CalFresh. (I verified it here; see Section 4.) But if you’ve applied to the health benefits exchange online, you have simply entered your information in CalHEERS, and the counties have access to it.
State law doesn’t require the counties to populate the CalFresh database with your information from CalHEERS, which is what Senator De Leon and the chorus of food policy advocates wanted. But it doesn’t seem to stop the counties from doing that either.
I suspect that that’s what has happened with the automatic CalFresh enrollments for people who’ve been enrolled in MediCal/Medicaid because of the Obamacare implementation. You didn’t have to check a CalFresh referral box at any point, if you entered your information online (or if you gave it over the phone and a service representative did it for you). Merely having your information in CalHEERS is enough to make it available to CalFresh – and some counties are automatically importing it to CalFresh and deeming you eligible.
It’s a working theory, anyway. Who knows what fresh delights await us as the beautiful logic of integrated data systems takes over our lives?