Medi-Cal Certified Eligibles
Recently, the Medi-Cal program has undergone substantial change. Individuals eligible for Medi-Cal residing in rural counties have been shifted from Medi-Cal’s traditional Fee-for-Service (FFS) delivery system to managed care plans. Children were transitioned from the Healthy Families Program (HFP) into Medi-Cal, and the Patient Protection and Affordable Care Act (ACA) has brought in millions of new Medi-Cal enrollees since December 2013.
Implementation of the ACA has heightened interest in the Medi-Cal program. Medi-Cal’s enrollment has grown significantly and stands at approximately one-third of California’s population. Policymakers, stakeholders, and researchers are interested in enrollment trends, the demographic make-up of the enrollees, and various subpopulations within Medi-Cal’s diverse overall population. To help answer the myriad of questions surrounding Medi-Cal’s changing enrollment and demographic trends, RASD has created the following tools to help describe the Medi-Cal population and identify many unique subpopulations of interest:
- Summary Tables allow users to examine the Medi-Cal certified eligible population by various demographics.
Counting and Reporting Medi-Cal Certified Eligibles
To determine the number of current enrollees, DHCS uses a special definition of Medi-Cal beneficiaries referred to as certified eligibles. When
working with certified eligible counts, it is important to consider whether the count is “preliminary” – referring to counts which are expected to grow
from updates in subsequent months – or “final” after 12 months of updates have been made to any given month. For an explanation of certified
eligibles and reporting timeframes, refer to this informational brief: "How Enrollment Statistics are Reported".
Certified Eligible Counts - Summary Tables
The following summary tables contain Medi-Cal certified eligible counts for the most current month of enrollment. The data tables include counts by county and the following four aid code groups: ACA Expansion Adult Age 19 to 64, Parent/Caretaker Relative & Child, Undocumented, and Other.
The following summary tables focus more on the ACA Expansion Adult Age 19 to 64 aid category and Non-ACA Expansion Adult eligibles for the most current month of enrollment. The data tables include counts by county, age group, race/ethnicity, and primary language.
The following summary tables show the most current month of enrollment for individuals ages 65 and older. The tables include counts by county, aid code group, and dual eligibility status.
Permissions and Sourcing
It is recommended that anything taken from this website be attributed to its original source. RASD includes suggested sources with each analytic product presented on this site.