Your utility keeps a list of the customers who can't do without electricity: oxygen concentrators, ventilators, home dialysis. In California they call it medical baseline. How long that list ought to be, nobody has established. The state's big utilities hired a consultant in 2024 to estimate how many households actually qualify, because for years enrollment targets had been set without a denominator.
A doctor's signature gets you enrolled. Staying reachable is a second errand nobody mentions — separately opting into outage alerts, keeping the phone number current.
What enrollment buys is notice. Utilities put it in writing that it does not buy faster restoration. And for unplanned outages, Seattle City Light's alert reaches you five to ten minutes after the lights are already off.
| Enrollment gets you | It doesn't get you |
|---|---|
| Advance warning of planned outages and wildfire shutoffs | Any warning of unplanned outages |
| 48 hours' notice before shutoff for nonpayment (where required) | Faster repair crews after the power drops |
| Extra electricity billed at the cheaper rate tier | A generator or battery |
| A flag on your account some crews and responders can see | Any guarantee of continuous service |
The national count: HHS's emPOWER map tracks 4.6 million Medicare patients dependent on electricity for equipment or care. It counts nobody on Medicaid only, private insurance, or no insurance at all.