What is Medi-Cal?

Low income families often have very limited and more often very discouraging options when it comes to affordable family health insurance. They end up with plans that are both inadequate and too expensive. Luckily some programs exist that help them acquire health insurance that is comprehensive and affordable. So what is Medi-cal? Medi-Cal is one of those programs.

Meeting the Health Needs of Californians

Medi-Cal is the Californian Medicaid program. It provides health care insurance for the most needy in California. The program helps needy families, the elderly, the disabled, and those with pre-existing conditions not covered by existing health insurance companies. Medi-Cal receives funding from state, local, and federal governments as well as independent fundraising. It further provides education and outreach programs designed to reach those who qualify for Medi-Cal assistance as well as those best poised to aid in the program’s goals.

The History of Medi-Cal

Medi-Cal was started in 1966, one year after the passage of federal Medicaid legislation. Designed to fulfill the promises of Medicaid, the program soon grew. By 1970 Medi-Cal expanded its coverage of long term care, a program Medicaid fails to address. In 1988, the program expanded to include low income families, distinguishing between welfare and medical programs, a first in Medicaid programs. In 1998 Medi-Cal began its Healthy Families program that focused  care on the earliest stages of life, giving low-income children the chance to have a health start.

The Recipients of Medi-Cal Coverage

Medi-Cal is currently the largest Medicaid program in the country. According to the Californian Health Care Foudnation, Medi-Cal currently serves over 6.8 million Californians and has a spending budget of over $47 billion. The program pays for almost half the births in the state and cares for some individuals for their entire lives. Over one third of California’s children receive care under the program and over two thirds of California’s seniors do.

Quality of Coverage

Medi-Cal differs from Medicaid coverage innotable ways. First, it doesn’t cover pharmacy benefits outright. Under Plan D, Medicaid pays for a portion of all pharmaceutical costs for seniors. However, Medi-Cal goes above and beyond Medicaid’s other programs. Medi-Cal helps lower the costs of long-term care for its recipients and requires no co-payments or deductibles from its lowest-income recipients. Medicaid requires at least some cost-sharing. Medi-Cal provides quality health care acces for the lowest income individuals without expectation of repayment.

The Future of Medi-Cal

The rising health care costs across the country pose a serious threat to the continuation of Medi-Cal’s programs. As the population ages and incomes diminish, revenues for the program will decline even as more people will qualify for care under Medi-Cal. Program directors will have to make some difficult decisions in the future to keep the program solvent and still honor the goals of the program. Do they cut benefits or do they change their funding strategy? They must decide carefully, as any changes will greatly affect California’s most desperate citizens.

Medi-Cal is the largest state Medicaid program in the country, and as such, it provides both a guide and a warning to other programs. California offers the most expansive benefits of any state Medicaid program, and it faces the largest funding problems. Medi-Cal’s successes and failures set a standard by which the rest of the country measures itself.

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