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Medi-Cal

California’s health system includes statewide public coverage programs and special county-based programs: Medi-Cal, Healthy Kids/Healthy Families, and others created under Section 1115 of the Social Security Act.


Improving the Health of Individuals Reentering Communities from the Criminal Justice System

The role of the Medi-Cal program in providing health care to Californians reentering the community from the criminal justice system expanded substantially in 2014. All citizens and legal permanent residents with incomes up to 138% FPL are now eligible,[1] and many individuals without minor dependent children in their households will […] more

Improving the Health of People Experiencing Homelessness: Issues and Recommendations

California’s decision to expand its Medicaid program provides federal funding opportunities to improve the health of its most vulnerable residents. Individuals experiencing homelessness have much to gain from Medi-Cal coverage, particularly considering that the homeless are in poorer health than their housed counterparts. Studies show that there is great potential […] more

Drug Medi-Cal Organized Delivery System Waiver Amendment Draft Special Terms and Conditions: A Summary and Comments

The Department of Health Care Services (DCHS) recently released revised draft special terms and conditions for the Drug Medi-Cal (DMC) Organized Delivery System (ODS) Waiver in October. This brief summarizes the main parts of the special terms and conditions (STCs) and provides comments about the most recent draft as the […] more

What’s Ahead for Covered California? Medium-Term Policy Considerations

Covered California has achieved great success in its first year. There are certainly needed improvements, and many are planned for the coming year, but California must not lose sight of the bigger picture. Thorough long- and medium-term planning for upcoming years is necessary to truly optimize the impact of the […] more

Transforming Drug Medi-Cal: Key Considerations for a Waiver Amendment

California’s expanded Medi-Cal program and expanded Substance Use Disorder (SUD) benefit provides an opportunity for beneficiaries to access improved services through the Drug Medi-Cal (DMC) program. In California, 1.9 million individuals are newly enrolled in Medi-Cal in 2014, [1] and an anticipated 147,000 to 195,000 of these individuals are in […] more

Updated – Better Coordinating Coverage for Pregnant Women: Putting Families First

Covered California plans and nearly all individual and employer-based health insurance plans offer maternity care.  California covers care for pregnant women through Medi-Cal (up to 200% of FPL), Access for Infants and Mothers (AIM) (up to 300% of FPL) and now Covered California covers maternity care (with premium subsidies up […] more

Children’s Health Coverage Under the ACA

This series examines the future of children’s coverage in California, both where we are now and where we need to go in the near future.  Topics discussed include: Current coverage of children Remaining uninsured children post ACA implementation Future of state programs like CHDP, AIM, CCS, and Family PACT Delivery […] more

On the Eve of Reform: Hospitals, Clinics and the Safety Net (2008-2011)

These reports are analyses of the Office of Statewide Health Planning & Development’s hospital and community clinic data that examines utilization and financing during the height of the Great Recession.  It looks into inpatient and outpatient care (hospitals), Medi-Cal utilization trends, county indigent care, as well as hospital utilization/financing trends […] more

Primary Care Rate Increases: Why Are They Important and What’s the Reason for the Delay in Implementation in California?

Download the full report here:   California could be the last state in the nation to implement the primary care improvements of the ACA, but if so, let’s at least make it the most successful, transformative and enduring. The ACA requires states to increase their Medi-Cal reimbursements for primary care […] more

Bridge Plan Legislation – Summary of SB X1 3 (Hernandez)

Download the PDF here:   SB X1 3 (Hernandez) sets the rules for Bridge Plans (Medi-Cal managed care plans) that can offer low cost continuation coverage in the Exchange for individuals losing Medi-Cal eligibility, and whole family coverage for families where the children are on Medi-Cal and the parents eligible […] more