Medi-Cal, California’s Medicaid program, is the state’s health insurance program for low-income Californians, including 40% of all children, half of all people with disabilities, over a million seniors, and nearly 4 million adults. It also pays for more than 50% of all births in the state and 58% of all patient days in long-term care facilities. In total, 13 million, or one in three, Californians rely on the program for health coverage. Medi-Cal pays for essential primary, specialty, acute, behavioral health, and long-term care services.
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The Patient Protection and Affordable Care Act (ACA) allowed states the option to expand Medicaid to low-income adults, and California has been an enrollment leader among the 37 states expanding their programs. In the spirit of advancing coverage, California also expanded Medi-Cal to low-income undocumented children and youth using only state resources in 2016.
Medi-Cal Facts and Figures: Crucial Coverage for Low-Income Californians presents data on the Medi-Cal program based on the most recent data available.
Key findings include:
Nearly two-thirds of Medi-Cal enrollees are composed of children and their parents/caretakers, children in the Children’s Health Insurance Program (CHIP), and seniors and people with disabilities.
In fiscal year 2018–19, Medi-Cal is projected to bring in more than $59 billion in federal funds and account for nearly 17% of state general fund spending.
80% of all Medi-Cal beneficiaries were enrolled in one of six managed care models.
Medi-Cal plays a crucial role in the California health care system. Its initiatives and demonstrations contribute to transforming the way health care is delivered in the state.
Medi-Cal has numerous initiatives and innovations focused on improving the quality and outcomes of care for its enrollees with complex chronic diseases, as well as reducing costs. Upcoming changes may bring new challenges and opportunities to Medi-Cal: Two of Medi-Cal’s waivers expire in 2020, prompting the need for decisions about which initiatives should continue and what new initiatives would best serve beneficiaries.