As Medicaid marks its 50th anniversary, two new developments in California help frame a fundamental forward-looking question:
What will Medi-Cal look like 50 years from now?
In its first 50 years, the partnership between federal and state governments to provide health coverage for low-income people grew differently in each state. In many ways, California embraced subsidized care, establishing programs and processes that were eventually emulated by other states.
Two relatively new evolutionary shifts may herald more change in California:
- Medi-Cal has grown substantially under the Affordable Care Act and now provides coverage for 12.7 million people, about one-third of the state’s population; and
- Federal officials approved a new five-year, $6.2 billion waiver plan to allow California to re-mold Medi-Cal in the post-reform era.
Medi-Cal’s growth and new programs will steer its course over the next decade or two. There will certainly be twists and turns in the road — such as the shift toward managed care and coordinated care for Californians dually eligible for Medi-Cal and Medicare. And there will be bumps, as well, such as the $1.1 billion hole left in this year’s budget with the expiration of the managed care organization tax.
We asked state officials, policy experts and consumer advocates what they predict for Medi-Cal over the next half century. We got responses from: