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Public Coverage

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.


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

Assistance With Premium Payments and Cost-Sharing – The Non-Federal Share

While the Affordable Care Act (extends health insurance to millions of Californians, not all will enroll. Between 3.1 and 4 million Californians may still lack health insurance in 2019. Many of the remaining uninsured will cite costs and affordability of coverage options as the primary reason for not enrolling. The […] more

The Tragedy of Prison Health Care in California: An Extended Timeline

While the Affordable Care Act has ensured that millions of Californians have access to affordable, quality health care, the same cannot be said for California’s prison and county jail inmates.  This timeline chronicles the fraught history of the state’s prison health care system, from 2002 to the present. January 30, […] 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

ITUP Draft Recommendations for the San Francisco Universal Health Council

Below are ITUP’s suggestions to the San Francisco Universal Health Council on revising the San Francisco Health Care Security ordinance’s employer health spending obligations in light of the passage of the Affordable Care Act. Download the complete document here:   ITUP’s recommendations are summarized as follows: For those employers with […] more

Children’s Health Under the ACA (draft)

This working draft 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 […] more

Providing Health Care to the Residually Uninsured in a Post-Reform World (Updated)

This updated version of ITUP’s 2012 report incorporates the latest research and data in regard to the Residually Uninsured. On March 23, 2010, the Patient Protection and Affordable Care Act (ACA) was signed into law, laying the groundwork for many health reforms, including the expansion of Medicaid, increasing coverage of […] more