Fiscal Year 2017-18
Projection: 130,930 active cases per month
Current Caseload: 116,862 active cases (as of April 2018)
Fiscal Year 2016-17
Projection: 132,216 active cases
Result: 122,324 active cases per month (average)
California's Medicaid program Medi-Cal is a public health insurance program that provides free or low-cost health care coverage to low-income individuals including families with children, seniors, persons with disabilities, children in foster care, pregnant women, single adults and low income people with specific diseases such as tuberculosis, breast cancer or HIV/AIDS. Medi-Cal pays for medical visits, hospital care, prescription drugs, pregnancy-related treatment, dental and eye care, and other medical services for individuals who do not have healthcare coverage.
How the Human Services Agency is Performing
Medi-Cal active caseload increased dramatically after the introduction of the Affordadable Care Act (ACA), but active enrollment has decreased slightly since September 2017.
Major provisions of the Affordable Care Act (ACA) were implemented in January 2014. With the implementation of the ACA, many of the participants in Healthy San Francisco became newly eligible for insurance through Medi-Cal Expansion starting January 2014, resulting in an 83 percent caseload increase within two years. The Human Services Agency (HSA) aims to further increase enrollment through outreach to the estimated 10,000 low-income San Franciscans who do not have health insurance.
Increased access channels for new applications and additional eligibility verification resources helped increase enrollment following ACA implementation. Increased promotion through health fairs and community events as well partnership with other agencies have contributed to eligible individuals learning about and enrolling in Medi-Cal, as have targeted enrollment efforts such as assisting jail inmates in applying for coverage prior to reentry, use of community based organizations (CBOs) to assist clients in applying online, and placing HSA staff in the community to conduct outreach and enrollment.
How Performance is Measured
This measure represents the number of Medi-Cal cases that have received coverage during the month for which the data is reported. The data source is CalWIN, an administrative database used in 18 California counties.
The monthly numbers presented are point-in-time active caseload counts while the annual projection value represents the projected monthly average paid cases for fiscal year (FY) 2016-17. These numbers are not directly comparable but do provide a monthly snapshot versus average monthly budgeted cases for the year.
The number displayed on the scorecard page represents a fiscal year average of active Medi-Cal cases shown in the chart above.
- View more resources or enroll in a Medi-Cal healthcare plan by visiting the Human Services Agency website.
- Learn more about enrollment trends in the San Francisco Health Network.
- Learn more about the California Department of Health Care Services Outreach and Enrollment Group.
- View information on California Department of Health Care Services Reports to the Legislature.
Please visit DataSF to view or connect with our scorecard data.