Medi-cal Win-win: Surging Enrollment Fosters Investment in the Safety Net

by Bobbie Wunsch; Tim Reilly

Dec 8, 2015
This summary brief looks at the post-ACA landscape through mid-2015 in terms of enrollment and health plan investments in the safety net. It highlights the main findings in Medi-Cal Managed Care Plans and Safety-Net Clinics Under the ACA. Buoyed by the expansion of Medi-Cal eligibility and benefits under the Affordable Care Act (ACA), the rolls of beneficiaries swelled from 7.5 million in 2010 to 12.4 million by early 2015. Complementary policy initiatives, through the Bridge to Reform 1115 Medicaid Waiver in California, have expanded mandatory Medi-Cal managed care enrollment to additional populations and geographies. The multiple policy and enrollment changes in 2013-2015 have resulted in new relationships, opportunities, and pressures for Medi-Cal managed care plans and safety-net clinics (see box), as MediCal has increased its reliance on managed care. This research examines the following questions:
  • How has enrollment in Medi-Cal managed care plans changed over this tumultuous period?
  • How are commercial and public Medi-Cal managed care health plans investing in safety net clinics?
  • What are the issues facing Medi-Cal managed care and its relationship to the safety net?
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