County Efforts to Expand Health Coverage Among the Uninsured in Six California Counties

Peter Long


This is archived content, for historical reference only.

In 1999, some 6.8 million Californians did not have health insurance coverage. About 2 million of these individuals (30%) were potentially eligible for existing publicly funded programs. But the remaining adults (4.3 million) and children (350,000) did not meet the eligibility requirements at that time.

To address gaps in public coverage at the state level, six California counties have expanded health insurance coverage or created access programs for uninsured individuals. While the California county governments are responsible for administering the Medi-Cal and Healthy Families programs, they also have primary responsibility for providing health care to uninsured individuals.

Six counties (Alameda, Contra Costa, San Francisco, San Joaquin, Santa Clara, and Solano Counties) that expanded coverage to bridge the gap in public programs are examined in this report. Each county has implemented different programs in its expansion effort and have targeted either children who were not eligible for Medi-Cal or Healthy Families or low-income uninsured adults.

The report identifies similarities and differences among these programs in terms of:

  • Target populations;
  • Benefits;
  • Outreach;
  • Enrollment;
  • Retention strategies; and
  • Lessons learned on the county and state levels.

The experiences of these counties provide important lessons for other county providers and policymakers. Issues such as administrative capacity, funding streams, and success rates are examined.

The complete report is available under Document Downloads below.