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State agencies describe waivers, plan requirements and emergency flexibilities to preserve Medi-Cal and insurer access after wildfires
Summary
The Department of Health Care Services and the Department of Managed Health Care told the Assembly committee they activated federal 1135 waivers, issued plan guidance and required health-plan notices to protect Medi‑Cal members and private-plan enrollees after the Southern California wildfires.
State health agencies told the Assembly Health Committee what they did to maintain access to care during the January wildfires: secured federal Medicaid (1135) flexibilities, required health plans to ease prescription and network restrictions, and coordinated with managed-care plans to support displaced members.
What DHCS did Michelle BOSS, Director of the Department of Health Care Services, testified that DHCS requested and received 36 separate federal CMS 1135 waivers to maintain continuity of care for Medi‑Cal members. The waivers and administrative actions included extended timelines for appeals and redeterminations, temporary authorization for services in alternate settings (mobile clinics, shelters, member homes), expedited pharmacy refills and authorization processing, and extensions for home-and-community-based-services timelines. DHCS said it extended renewal periods for impacted Medi‑Cal members (February–April redeterminations) by six months and reinstated members who had been disenrolled in January 2025 to avoid coverage gaps. The department also launched a Southern California fires website with waiver updates and member resources.
What DMHC required of private insurers Mary Watanabe of the Department of Managed Health Care told the committee that within 48 hours of a proclaimed emergency, licensed plans must file notices of expected operational disruptions and the actions they will take. DMHC issued an "all plan letter" on Jan. 9 directing plans to provide a toll-free number for impacted enrollees, prominently post instructions on plan websites and suspend refill limits and prior-authorization barriers so enrollees could obtain out-of-network care at in-network cost-sharing when necessary.
Hospital and community-health system impacts Huntington Health (President/CEO Dr. Lori Morgan) described strained hospital operations: surge emergency volumes from evacuated skilled-nursing patients, elevated respiratory and cardiac admissions, dialysis interruptions as nearby centers closed, canceled elective procedures, and staffing shortages after more than 50% of employees were displaced. AltaMed described temporarily closed clinics, diversion of about 6,000 visits and an on-site evacuation response where bilingual community health teams delivered care, hygiene supplies and infection control at the convention-center evacuation site.
Why this matters: State waivers and plan directives preserved access for vulnerable Medi‑Cal members and private enrollees, but hospitals reported revenue losses, staffing stress and long-term costs for recovery and workforce housing.
Ending: State officials said flexibilities and coordination preserved care during the emergency; hospital CEOs and community health centers urged further sustained funding for behavioral health, staff housing, and workforce development to support recovery.
