The health care safety net consists of the programs and providers that serve Californians with low incomes. The largest safety-net program in the state is Medi-Cal, which provides health insurance coverage to most legal residents earning less than 138% of the federal poverty level. Many Californians earning more than this threshold have gained subsidized insurance through Covered California, the state’s health insurance exchange.

Safety-net health care providers have a legal mandate or explicit mission to provide care for patients who have low incomes and/or are uninsured. These providers include various types of hospitals, clinics, and private doctors, many of whom have seen increased demand for their services in recent years.

California’s Health Care Safety Net: Essential Access for Millions presents data on the providers and programs that compose California’s safety-net system.

Key findings include:

• Federally Qualified Health Centers (FQHCs) are an important component of the state’s safety net. The number of patients receiving care at FQHCs increased by 60% between 2013 and 2019. FQHCs saw 5.3 million patients in 2019, up from 3.4 million in 2013.The number of organizations serving these patients increased by nearly 40%.
• Nearly two-thirds of FQHC patients were covered by Medi-Cal in 2019.
• Community health center margins, though still positive, have declined since 2016. The median margin was 6.5% in 2016 but only 2.5% in 2019.
• Between 2015 and 2019, both nonprofit and investor hospitals served more Medi-Cal members, with increases in inpatient days and outpatient visits.

The full report, and all the charts found in the report, are available for download below. These materials are part of CHCF’s California Health Care Almanac, an online clearinghouse for key data and analyses describing the state’s health care landscape. See our entire collection of current and past editions of California’s Health Care Safety Net.