Skip to content

Return to the Full Article View You can republish this story for free. Click the "Copy HTML" button below. Questions? Get more details.

How To Design, Deliver New, Improved Medi-Cal

If it works the way it’s supposed to, health care reform will usher in a new era in which health coverage is the rule rather than the exception for everybody, regardless of social strata, income or where you work. One of the main vehicles to this new “culture of coverage” will be Medicaid, but it probably won’t be — and perhaps shouldn’t be — your father’s Medicaid.  

The expansion of Medicaid under the Patient Protection and Affordable Care Act offers the opportunity to redefine and redesign a program that for its first half century has been perceived first as a part of welfare and then as a safety net for poor people.

According to a new report from the Kaiser Commission on Medicaid and the Uninsured, Medicaid program directors, experts and thought leaders see several opportunities for ways to create a new, improved system for the 21st century. For the new Medicaid to be successful, it will need a new public image, according to the KCMU issue paper, “Optimizing Medicaid Enrollment: Perspectives on Strengthening Medicaid’s Reach under Health Care Reform.” Consensus among those interviewed for the paper is that the planned expansion of Medicaid offers a strategic opportunity to recast the program as an affordable option for working people and families, as well as to improve its enrollment and renewal operations.

How California’s Medi-Cal, the nation’s largest Medicaid program with more than seven million participants, approaches this new “culture of coverage” could be a major factor in how successful health care reform is in California.

We asked experts:  

  • How can the system be redesigned to not only deal with many more participants but to encourage a whole new portion of the state’s population to consider Medi-Cal as an option?
  • For many potential new participants, the thick red tape associated with government programs may be a serious detraction. How can California streamline the process?
  • In addition to expanding Medi-Cal, California will be setting up a health insurance exchange offering discounted and subsidized coverage for those who don’t qualify for Medi-Cal. Should the state create one screening process to handle both the exchange and Medi-Cal?

We got responses from:

KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism about health issues. Together with Policy Analysis and Polling, KHN is one of the three major operating programs at KFF (Kaiser Family Foundation). KFF is an endowed nonprofit organization providing information on health issues to the nation.

Some elements may be removed from this article due to republishing restrictions. If you have questions about available photos or other content, please contact