Extreme (Medi-Cal) Makeover

There’s no question the Affordable Care Act, the new federal health reform law, will transform California’s – and the nation’s – health care system. And a big part of the transformation will occur in the Medicaid Program, known as Medi-Cal in California.

Medi-Cal, which has humbly provided health coverage to millions of low-income children, seniors, and persons with disabilities for 45 years, is due for a makeover. In a new CBP report, we project that by 2019, Medi-Cal coverage could climb to as high as 10.5 million under the new health law. In contrast, the program currently serves more than 7 million individuals, with approximately 500,000 more Californians eligible, but not enrolled. This significant expansion of Medi-Cal eligibility, and likely enrollment of millions of previously uninsured Californians, offers new opportunities.

First, we estimate that generous federal funding will allow California to draw down nearly $30 in federal funds for each state dollar it invests in coverage for newly eligible adults between 2014 and 2019. Thus, for an extraordinarily modest investment, the state could potentially provide more than a million Californians with comprehensive health coverage.

Second, the new health law declares that any person with an income below 138 percent of the federal poverty line is eligible, which makes it easier for certain individuals to enroll and stay enrolled in Medi-Cal. California Health and Human Services Secretary Kim Belshe said last week that Medi-Cal will be a program “grounded in covering people,” and federal officials are urging a new “triple-E” mantra – “Eligibility Equals Enrollment.”

The transformation of Medi-Cal couldn’t come at a better time. As recent Census data have shown, the share of nonelderly Californians with job-based coverage has declined significantly since the beginning of the decade. Soon, Medi-Cal may help to fill that gap.

– Hanh Kim Quach