Maternity Care and Paying for Maternity Services

Medi-Cal Explained: Fact Sheets

Melora Simon


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Medi-Cal Explained

These fact sheets are part of CHCF’s Medi-Cal Explained series. The series provides an overview of the program, including the people it serves, the services it provides, and how it is organized, managed, and financed.

Note: Senate Bill 1237 was signed into law in September 2020. It modifies scope of practice laws for certified nurse midwives, eliminating the requirement that they work under physician supervision.

Almost 500,000 babies are born every year in California — and Medi-Cal plays an outsized role in covering those births. Thresholds for Medi-Cal eligibility are more generous when people become pregnant. As a result, although Medi-Cal covers one in three Californians, it pays for nearly one in two of the state’s births. Still, from a cost perspective, maternity care is a relatively small piece of all that Medi-Cal covers. Estimates show that spending on live births is less than 2% of all Medi-Cal spending.

CHCF’s Medi-Cal Explained series has two fact sheets available for readers who are either new to Medi-Cal and maternity services or for those who need a refresher, as follows:

  • Medi-Cal Explained: Maternity Care is an overview of coverage, including eligibility requirements, covered services, and a brief description of payment.
  • Medi-Cal Explained: Paying for Maternity Services includes much more detail about how Medi-Cal pays for maternity services, including professional and facility reimbursement under fee-for-service, and how California’s Department of Health Care Services pays managed care plans.