CHA News Article

DHCS/Covered California Release California Eligibility and Enrollment Report: Insurance Affordability Programs

The California Department of Health Care Services (DHCS) and Covered California have released the quarterly California Eligibility and Enrollment Report: Insurance Affordability Programs, pursuant to California Assembly Bill X1-1 (Chapter 3, First Extraordinary Session, Statutes of 2013), which requires quarterly reporting on eligibility and enrollment processes for all California insurance affordability programs, including Medi-Cal, the Medi-Cal Access Program (formerly AIM) and qualified health plans available through Covered California. The report presents application, eligibility and enrollment data from Oct. 1, 2014, through Dec. 31, 2014.

Key report findings include:

  • Total (net) Medi-Cal enrollment increased by approximately 240,000.
  • Approximately 910,000 individuals applied and were determined eligible for Medi-Cal; 340,000 applied and were determined eligible for enrollment in qualified health plans through Covered California.
  • Three million cases were due for renewal of Medi-Cal, and 82 percent resulted in continued Medi-Cal coverage.
  • More than one-quarter (28 percent) of applicants reported that their primary spoken language was Spanish. About 45 percent of new Medi-Cal enrollees and 37 percent of those who selected a qualified health plan and reported an ethnicity during this reporting period identified as Hispanic.
  • 71 percent of applications determined eligible for Covered California qualified health plans were filed with assistance (similar to the previous reporting period).
  • Approximately 51 percent of all applications submitted through CalHEERS were initiated online (with and without assistance).

The report focuses on the initial steps and outcomes of the enrollment process for new applicants during this reporting period, including the venues through which applications were received, consumer assistance in filing applications, applicant demographics, resulting eligibility determinations, enrollee demographics, plan enrollment choices, and the volume and outcome of eligibility appeals. Future quarterly reports will incorporate additional measures – such as trends in disenrollment among current enrollees – as data become available.The full report is attached.