Medi-Cal Facts and Figures: A Program Transforms

The Lewin Group

Medi-Cal is the main source of health insurance for one in five Californians. This report provides an overview of the program's key features, describes how the program is evolving, and examines the challenges ahead.

May 2013

Medi-Cal, California's Medicaid program, pays providers for essential primary, specialty, acute, and long-term care services delivered to more than seven million Californians: children, their parents, pregnant women, seniors, and nonelderly adults with disabilities. In fiscal year 2012-13, Medi-Cal is projected to draw more than $37 billion in federal funds into the state's health care system and will account for nearly 23% of general fund spending.

The program is in the midst of a major transformation as it shifts most enrollees to managed care and prepares for a major expansion due to the Patient Protection and Affordable Care Act (ACA). Enrollment will surge in 2013 as more than 850,000 children transition to Medi-Cal from the Healthy Families Program. Medi-Cal will see an estimated total increase of a million or more enrollees due to the ACA, including 680,000 people in 2014, the first year of Medi-Cal expansion under health reform.

As Medi-Cal evolves, it faces numerous challenges, including ensuring that enrollees have appropriate access to care and controlling health care costs. Medi-Cal Facts and Figures: A Program Transforms serves as an up-to-date overview of Medi-Cal, covering program eligibility and enrollment, benefits, service delivery, background on policy issues, budget, and forces that affect the program's costs.

The complete report, all the charts found in the report, and the 2009 edition, are available under Document Downloads.