History of Medi-Cal in Timeline

Medi-Cal is California's implementation of the federal Medicaid program, providing healthcare to low-income individuals and families. Established in 1965, it covers a wide range of services, including ambulatory care, emergency services, hospitalization, maternity care, mental health, dental, and vision. In 2022, over 15.28 million Californians, approximately 40% of the state's population, were enrolled. In certain counties, enrollment exceeds 50%. As of 2025, about 56% of children in California use the program. Medi-Cal plays a crucial role in ensuring access to healthcare for vulnerable populations in California.

1933: California Law Requirement

Since 1933, California law has required counties to provide relief to the poor, including health care services.

1965: Social Security Amendments

Federal law mostly consists of the Social Security Amendments of 1965, which added Title XIX to the Social Security Act.

1965: Medi-Cal Creation

In 1965, Medi-Cal was created by the California Medical Assistance Program a few months after the national legislation was passed.

2005: Recommendations for Improvement

In 2005, the California Health Care Foundation recommended steps to improve Medi-Cal managed care plans, resulting in contract changes.

2011: CMS Approval of Bridge to Reform

In 2011, CMS approved a Section 1115 Medicaid waiver called Bridge to Reform, which included expansion of patient-centered medical homes, the Low Income Health Program (LIHP), and incentive pay-for-performance for hospitals.

2014: Eligibility Expansion under PPACA

In 2014, under the Patient Protection and Affordable Care Act (PPACA), Medi-Cal eligibility was extended to those with family incomes up to 138% of the federal poverty level.

2014: Transition to Medi-Cal

In 2014, when the Patient Protection and Affordable Care Act took effect, many patients from both the CMSP and MISP county programs transitioned to Medi-Cal.

2014: Medi-Cal Costs

Medi-Cal costs were estimated at $73.9 billion ($16.9 billion in state funds) in 2014-15.

September 2015: High Enrollment in Certain Counties

As of September 2015, over 50% of residents in both Tulare County and Merced County were enrolled in Medi-Cal.

2015: Waiver Renewal

In 2015, the waiver was renewed, extending the program to 2020 in an initiative called Medi-Cal 2020, adding programs such as alternative payment systems, the Dental Transformation Initiative, and the Whole Person Care program.

2015: Medi-Cal Costs

Medi-Cal costs were estimated at $73.9 billion ($16.9 billion in state funds) in 2014-15.

2017: Reporting on Core Sets

In 2017, it reported on 13 of the 20 frequently reported from the CMS Medicaid/CHIP Child Core Set and 15 of 19 frequently reported from the CMS Medicaid Adult Core Set.