Expansion of Medicaid in California

Coverage expansion through the Affordable Care Act (ACA) transformed how public health care systems provide care in California’s communities. The ACA offered an unprecedented expansion of insurance coverage to low-income Californians, with Medicaid (Medi-Cal) enrollment increasing from 8.6 million prior to the ACA to over 13 million in 2016. A stable coverage landscape enabled a shift in focus from costly acute care to more cost-effective primary and preventive care services with a focus on improved health outcomes and quality, efficiency – right care in the right place at the right time, and better care coordination.

Prior to the ACA, California set the foundation for coverage expansion through the Health Care Coverage Initiative and the Low Income Health Program (LIHP), both from early 1115 Medicaid waivers. Those individuals enrolled in LIHP were seamlessly transitioned into Medi-Cal when the ACA rolled out in 2014. California’s public health care systems then became the primary care provider to more than 500,000 patients who become eligible for Medi-Cal through coverage expansion.

With these programs, California’s public health care systems emerged as leaders in ACA implementation and delivery system transformation. With threats to dismantle medicaid expansion and/or repeal coverage expansion, CAPH remains steadfast in its support of these efforts.

Impact of Medicaid Expansion