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Medi-Cal Expansion under the Affordable Care Act: Significant Increase in Coverage with Minimal Cost to the State

January 1, 2013

Since 2011, California has been taking steps towards expanding Medicaid under the Afordable Care Act (ACA) by implementing Low Income Health Programs (LIHPs) in most California counties. Under the "Bridge to Reform" Medicaid §1115 waiver, just over 500,000 California adults are currently enrolled in coverage in advance of ACA implementation using federal and county funds. he vast majority of these LIHP enrollees can become eligible for Medi-Cal coverage under the ACA beginning January 1, 2014, and the remainder will be eligible for subsidies through Covered California (the California Health Benefit Exchange).In early 2013, California legislators will consider bills to implement a key provision of the ACA that would expand Medi-Cal to low-income adults under age 65, including those without children living at home. Lawfully-present childless adults with income up to 138 percent of the Federal Poverty Level and parents with income between 106 percent and 138 percent of the Federal Poverty Level will be newly eligible. Some unenrolled children and parents who are already income-eligible for the program under existing eligibility rules could also enroll due to the minimum coverage requirement to obtain insurance created by the ACA, improved eligibility, enrollment and redetermination processes, and enhanced awareness of coverage options.In this report, we estimate the growth in Medi-Cal enrollment among both the newly and already eligible using the UC Berkeley-UCLA California Simulation of Insurance Markets (CalSIM) model. We discuss the broader impact of the Medi-Cal Expansion in terms of health outcomes, providers and the economy. We estimate the federal and state spending on increased Medi-Cal enrollment, along with the state tax revenues generated by new federal Medi-Cal spending and potential savings in other areas of the budget.

Achieving Equity by Building a Bridge From Eligible to Enrolled

February 28, 2012

Calls for multilingual outreach and enrollment efforts to enable Californians of color and those with limited English proficiency to benefit from the Health Benefit Exchange. Recommends targeting high-need groups and strengthening data collection.

The State of Health Insurance in California: Findings From the 2009 California Health Interview Survey

February 3, 2012

Analyzes sources of coverage and uninsurance rates by county, effects of declines in income and employer-sponsored insurance, disparities, access to and affordability of care, role of public insurance, and projected impact of federal healthcare reform.

Newly Insured Californians Would Fall by More than 1 Million Under the Affordable Care Act Without the Requirement to Purchase Insurance

January 11, 2012

Compares the estimated number and percentage of currently uninsured Californians who will be insured by 2019 under the Affordable Care Act with the individual mandate and without. Highlights the need for the mandate to ensure affordable coverage.

Proposed Regulations Could Limit Access to Affordable Health Coverage for Workers' Children and Family Members

December 12, 2011

Outlines implications of how the health reform law's premium subsidies apply if employer-sponsored self-only coverage is affordable but family coverage is not. Suggests basing family members' eligibility and affordability on additional cost to employee.

12-Month Continuous Eligibility in Medicaid: Impact on Service Utilization

December 31, 2010

Summarizes findings on how allowing Medicaid enrollees to remain enrolled without reapplying for twelve months affected the number of Medi-Cal-enrolled children's emergency room visits and physician visits compared with those with discontinuous coverage.

Number of Uninsured Jumped to More Than Eight Million from 2007 to 2009

March 16, 2010

Updates 2007 California Health Interview Survey data with estimates for 2009 population growth and changes in insurance status among the non-elderly. Examines trends by source of coverage and explores contributing factors.

Health Coverage Expansion in California: What Can Consumers Afford to Spend?

September 1, 2007

Analyzes Californians' current spending on insurance premiums and out-of-pocket expenditures to assess whether proposals to make obtaining health insurance mandatory include sufficient measures to make it affordable for low- and middle-income families.

What Does It Take for a Family to Afford to Pay for Health Care?

August 1, 2007

Addresses how much Californians can afford to pay for health care based on their current insurance premiums and out-of-pocket expenses as well as other basic necessities, such as housing, child care, transportation, food, and taxes.