CHA News Article

DHCS, Covered California Release Quarterly Eligibility and Enrollment Report
Highlights how many Californians have gained health coverage under the ACA

The California Department of Health Care Services and Covered California have released their quarterly report on eligibility and enrollment processes for all California insurance affordability programs, including Medi-Cal, the Medi-Cal Access Program (formerly the Access for Infants and Mothers program) and qualified health plans (QHPs) available through Covered California. The report — required under Assembly Bill X1-1 (Chapter 3, Statutes of 2013) — details pathways and outcomes for new applicants, including application sites, consumer assistance, applicant demographics, resulting eligibility determinations, plan enrollment choices, and the volume and outcome of eligibility appeals.

Key findings from the July 2015 report, which covers the final quarter of 2014, include:

  • Total Medi-Cal enrollment increased by 271,344 to 11,983,768.
  • Approximately 710,000 individuals applied and were determined eligible for Medi-Cal; 340,000 applied and were determined eligible for enrollment in QHPs through Covered California. Of these QHP enrollees, 86 percent are receiving advance premium tax credits and/or cost-sharing assistance.
  • 82 percent (2.46 million) of Medi-Cal renewals resulted in continued Medi-Cal coverage.
  • 1.1 million individuals were eligible for renewal of QHP coverage, and 92 percent were renewed. Of these, 94 percent remained with the same carrier. Children and youth 0-17 accounted for 31 percent of applicants, and young adults 18-25 for another 15 percent.
  • 73 percent of applications determined eligible for Covered California QHPs were filed with assistance.
  • Approximately 37 percent of all applications submitted through the California Healthcare Eligibility, Enrollment and Retention System were initiated online (with and without assistance).

The report covering the final quarter of 2014, and the previous report covering the year from October 2013 to September 2014, are attached.