Medi-Cal Expansion

Latest Medi-Cal News

Updated 10/28/2015

There have been a number of developments regarding Medi-Cal over the past few months, including:

1115 Waiver Update: The Department of Health Care Services (DHCS) is in continuing negotiations with CMS over the final details of California’s 1115 waiver. Unfortunately, California’s major financing mechanism for the waiver, which is based on federal/state shared savings, is now facing legal barriers. As a result, the state must identify and use other sources of non-federal share to fund as much as possible of their current waiver proposal. The existing “Bridge to Reform” waiver remains in effect through October 31, 2015.

Medi-Cal Demographic Reports: In September, DHCS and Covered California released the latest quarterly report on application, eligibility, and enrollment data for Medi-Cal, the Medi-Cal Access Program, and Qualified Health Plans available through Covered California covering the period from January 1, 2015 through March 31, 2015. The data shows that enrollment in health coverage continues to grow, with Medi-Cal enrollment expanding by 240,000 over the three months. While a large number of non-respondents to the race and ethnicity questions on the application make it challenging to know for certain the demographic makeup of enrollees, it is clear that a majority come from communities of color. We do have some concerns that the number of applicants in languages other than English (~28%) is lower than the expected enrollment for Limited English Proficient individuals (~35%). We will express our concerns about that number and work to understand why there is such a gap. Also in September, DHCS released the latest Medi-Cal Managed Care Performance Dashboard, which details the demographic makeup of enrollees. From this report, we can see that communities of color make up 79% of the Medi-Cal population, with Latinos representing nearly half (47%). This dashboard will be regularly updated and will help us better understand the demographics of the Medi-Cal population.

Gaps in Access to Medi-Cal Coverage: July 2015 report, released by the UCLA Center for Health Policy Research, found significant gaps in access to care in the Medi-Cal program compared to those with employer-sponsored insurance. The report, which relies on 2012-13 California Health Interview Survey data, provides a baseline to compare differences in access to care as more and more Californians gain health coverage under the ACA. Of particular note, while Asian American and Latino Medi-Cal enrollees reported greater difficulty in communicating with their physicians, Spanish speakers, including those who speak both English and Spanish at home, had the greatest difficulty finding either a doctor or a specialist who would accept them as a new patient. CPEHN will continue to monitor quality improvement initiatives in Medi-Cal so health coverage is accessible for all Medi-Cal enrollees.

For past news on Medi-Cal, please visit our Medi-Cal archive.