Medi-Cal Monthly enrollment fast facts - June 2016

Revised May 20, 2014 Using MIS-DSS Data

0

Research and Analytic Studies Division

MEDI-CAL MONTHLY ENROLLMENT FAST FACTS Characteristics of the Medi-Cal population as captured by the Medi-Cal Eligibility Data System (MEDS)

The enrollment data included in this document represent only certified eligible counts. Certified eligibles are those beneficiaries deemed qualified for Medi-Cal by a valid eligibility determination, and who have enrolled into the program. This classification excludes beneficiaries who have a monthly share-of-cost obligation that has not been met, as well as other specific populations. Enrollment counts exclude information related to applications received or any other eligibles that may be in the process of becoming certified eligible.

The counts presented are considered PRELIMINARY and subject to change. The certified eligible counts reflected in this document incorporate three Medi-Cal eligibility updates and reflect roughly 99.2% of all Medi-Cal certified eligibles for the most recent month displayed. A specific month’s enrollment count is considered complete for statistical reporting purposes 12 months after the month’s end.

June 2016 As of the MEDS Cut-off

for September 2016

Department of Health Care Services, Research and Analytic Studies Division 1

June 2016 Certified Eligible Statistics – Medi-Cal Population As of the MEDS Cut-off for September 2016

7,864,9658,605,691

13,570,391

01,000,0002,000,0003,000,0004,000,0005,000,0006,000,0007,000,0008,000,0009,000,000

10,000,00011,000,00012,000,00013,000,00014,000,00015,000,000

Cert

ified

Elig

ible

s

Month

Figure 1: Medi-Cal Certified Eligibles, January 2013 through June 2016

1,207,687 1,237,869

1,399,689

759,220 762,319 743,988

0

200,000

400,000

600,000

800,000

1,000,000

1,200,000

1,400,000

1,600,000

Cert

ified

Elig

ible

s

MonthDual Medi-Cal Only SPD

Figure 2: Medi-Cal Certified Eligibles – Dual Eligibles & Medi-Cal-Only Seniors and Persons with Disabilities (SPDs), January 2013 through June 2016


Figure 3: Medi-Cal Certified Eligibles by Aid Category, June 2016*

Figure 4: Gender

Figure 5: Age Group***


3,688,864

157,702

1,310,666

54,461

168,480

5,490,854

2,003,112

696,252

- 2,000,000 4,000,000 6,000,000

ACA Expansion Adult – Ages 19 to 64

Adoption/Foster Care

CHIP

LTC**

Other

Parent/Caretaker Relative & Child

Seniors and Persons with Disabilities

Undocumented

Certified Eligibles

Aid

Cate

gory

5%

15%

40%

1%

<1%

10%

1%

27%

Female7,270,835

54%

Male6,299,556

46%

13,570,3910-20

5,709,89642%

21-646,741,143

50%

65+1,119,352

8%

13,570,391

*Refer to the Appendix for detailed aid code groupings. **Individuals residing in a long-term care facility. ***Seven certified eligibles without age data were grouped in the “0-20” age cohort.



Figure 6: Race/Ethnicity

Figure 7: Delivery System

Figure 8: Dual Status

Figure 9: ACA Expansion Adult – Ages 19 to 64

Asian/ Pacific

Islander1,733,179

13%

African American1,028,149

8%

Hispanic6,461,324

48%

Not Reported1,558,981

11%

American Indian/ Alaskan Native56,682

<1%

White2,732,076

20%13,570,391

Fee-for-Service

2,883,13121%

13,570,391

Managed Care

10,687,26079%

Dual1,399,689

10%

13,570,391

Non-Dual12,170,702

90%

ACA Expansion

Adult -Ages 19

to 643,688,864

27%

All Other Aid

Categories9,881,527

73%

13,570,391



Figure 10: Medi-Cal Enrollees by Delivery System, January 2013 through June 2016

Figure 11: Aid Group for Fee-for-Service Participants

Figure 12: Aid Group for Managed Care Participants

2,801,272 2,505,614

2,883,131

5,063,6936,100,077

10,687,260

0

1,000,000

2,000,000

3,000,000

4,000,000

5,000,000

6,000,000

7,000,000

8,000,000

9,000,000

10,000,000

11,000,000

12,000,000

Cert

ified

Elig

ible

s

MonthFee-for-Service Managed Care

Undocumented 695,612

24%

Parent/CaretakerRelative & Child

709,56525%

SPD473,470

16%

Other151,329

5%

Adoption/Foster Care97,0623% CHIP

83,8013%

LTC28,179

1%

ACA Expansion

Adult –Ages 19 to

643,044,751

28%

Adoption/ Foster Care

60,6401%

CHIP1,226,865

11%

LTC26,282

<1%

Other17,151

<1%

Parent/ Caretaker Relative &

Child4,781,289

45%

SPD1,529,642

14%Undoc-

umented640<1%

10,687,2602,883,131

ACA Expansion Adult – Ages 19 to 64

644,113 22%


Figure 13: Language


English8,380,828

62%

Spanish4,069,085

30%

Unknown152,328

1%

Armenian74,579

1%

All Chinese**262,229

2%

Vietnamese223,156

2%

All Other*408,186

3%Other968,150

7%

Total = 13,570,391

905,4494,485,236

8,630,920

9,002,3087,884,190

4,939,471

9,907,757

12,369,426

13,570,391

0

2,000,000

4,000,000

6,000,000

8,000,000

10,000,000

12,000,000

14,000,000

16,000,000

Figure 14: Medi-Cal Certified Eligibles, MAGI and Non-MAGI, January 2014 through June 2016

MAGI Non-MAGI Grand Total

Month

Cert

ified

Elig

ible

s

Note: Many certified eligibles in Non-MAGI aid codes are transitioned into MAGI aid codes during the redetermination process.

*“All Other” includes: ASL, Arabic, Cambodian, Farsi, French, Hebrew, Hmong, Ilocano, Italian, Japanese, Korean, Lao, Mien, Other Non-English, Other Sign, Polish, Portuguese, Russian, Samoan, Tagalog, Thai, and Turkish. **“All Chinese” includes certified eligibles who indicated their primary language as Mandarin, Cantonese, or “Other Chinese.”



MAGI8,630,920

64%

Non-MAGI4,939,471

36%

Figure 15: Medi-Cal Certified Eligibles by MAGI Status

13,570,391

Male4,064,761

47%

Female4,566,159

53%

Figure 16: Gender for MAGI

8,630,920 Female2,704,676

55%

Male2,234,795

45%

Figure 17: Gender for Non-MAGI

4,939,471



0-203,631,250

42%

21-644,994,452

58%

65+**5,218<1%

Figure 18: Age Group for MAGI*

8,630,9200-20

2,078,64642%

21-641,746,691

35%

65+1,114,134

23%

Figure 19: Age Group for Non-MAGI***

4,939,471

1,102,952

2,675,030

3,688,864

0

500,000

1,000,000

1,500,000

2,000,000

2,500,000

3,000,000

3,500,000

4,000,000

Figure 20: ACA Expansion Adult – Ages 19 to 64, Since January 2014

ACA

Expa

nsio

nAd

ults

Age

s 19-

64

Month

*Four certified eligibles categorized as MAGI and without age data were grouped in the “0-20” age cohort. **Some MAGI aid codes do not have age restrictions. ***Three certified eligibles categorized as Non-MAGI and without age data were grouped in the “0-20” age cohort.


Figure 21: ACA Expansion Adult – Ages 19 to 64 – Gender

Figure 22: ACA Expansion Adult – Ages 19 to 64 – Age Group

Figure 23: ACA Expansion Adult – Ages 19 to 64 – Race/Ethnicity

Figure 24: ACA Expansion Adult – Ages 19 to 64 – Delivery System


Female1,796,801

49%

Male1,892,063

51%3,688,864

0-20243,899

7%

21-643,444,965

93%

3,688,864

American Indian/ Alaskan Native18,417

1%

Asian/ Pacific

Islander631,181

17%

African-American289,299

8%

Hispanic1,378,809

37%White951,737

26%

3,688,864

Not Reported419,42111%

Fee-for-Service644,113

17%

Managed Care

3,044,75183%

3,688,864


Figure 26: ACA Expansion Adult – Ages 19 to 64 – Language


55,9481%

110,9083%

3,181,750 86%

317,8369%

22,602 1%

Figure 25: ACA Expansion Adult – Ages 19 to 64 – Aid Code

7U-Express Lane Enroll(XIX) Adults Ages 19–64 FS No SOC

L1-LIHP/MCE transition to Medi-Cal

M1-Adult 19 to 64 at or below 138%FPL Citizen/Lawful

M2-Adult Undoc 19-<65, 0-138% FPL

P3-Hospital PE Adult, 0-138% FPL

Total =3,688,864

English2,614,784

71%

Spanish810,836

22%

Unknown4,217 <1%

All Chinese**83,697

2%Korean20,165

1%

Vietnamese72,403

2%

All Other*82,762

2%Other259,027

7%

Total = 3,688,864

*All Other” includes: ASL, Arabic, Armenian, Cambodian, Farsi, French, Hebrew, Hmong, Ilocano, Italian, Japanese, Lao, Mien, Other Non-English, Other Sign, Polish, Portuguese, Russian, Samoan, Tagalog, Thai, and Turkish. **“All Chinese” includes those who indicated their primary language as Mandarin, Cantonese, or “Other Chinese.”



Appendix 1 Table 1: Medi-Cal Aid Categories and Aid Codes

Aid Category Corresponding Primary Aid Codes ACA Expansion Adult - Ages 19 to 64*

7U, L1, M1, P3

Adoption/Foster Care 03, 04, 06, 07, 40, 42, 43, 45, 46, 49, 2P, 2R, 2S, 2T, 2U,4A, 4E, 4F, 4G, 4H, 4L, 4M, 4N, 4S, 4T, 4W, 5K

CHIP

5C, 5D, 5E, 7X, 8P, 8R, 8X, E2, E6, E7, H0, H1, H2, H3, H4, H5, H6, H9, L2, L4, M5, T1, T2, T3, T4, T5

LTC 13, 23, 53, 63 Other

01, 02, 08, 0A, 0L, 0M, 0N, 0P, 0R, 0T, 0U, 0V, 0W, 0X, 0Y, 2A, 2V, 44, 4K, 4V, 5V, 65, 71, 73, 76, 77, 7F, 7G, 7H, 7M, 7N, 7P, 7R, 7V, 81, 82, 83, 86, 87, 8E, 8W, 90, F1, F2, F3, F4, F5, F6, F7, F8, G0, G1, G2, G3, G4, G5, G6, G7, G8, G9, J1, J2, J3, J4, J5, J6, J7,J8, M9, N0, N5, N6, N7, N8, N9, R1

Parent/Caretaker Relative & Child

3N, 30, 32, 33, 34, 35, 37, 38, 39, 3A, 3C, 3D, 3E, 3F, 3G, 3H, 3L, 3M, 3P, 3R, 3U, 3W, 47, 54, 59, 5X, 6R, 72, 7A, 7J, 7S, 7T, 7W, 8U, 8V, H7, H8, K1, M3, M7, P1, P2, P4, P5, P7, P9

Seniors and Persons with Disabilities

10, 14, 16, 17, 18, 1E, 1H, 1X, 1Y, 20, 24, 26, 27, 28, 2E, 2H, 36, 60, 64, 66, 67, 68, 6A, 6C, 6E, 6G, 6H, 6J, 6N, 6P, 6S, 6V, 6W, 6X, 6Y, 8G

Undocumented

1U, 3T, 3V, 48, 55, 58, 5F, 5H, 5J, 5M, 5N, 5R, 5T, 5W, 5Y, 69, 6U, 70, 74, 7C, 7K, 8N, 8T, C1, C2, C3, C4, C5, C6, C7, C8, C9, D1, D2, D3, D4, D5, D6, D7, D8, D9, L3, L5, M0, M4, M6, M8, P0, P6, P8, T0, T6, T7, T8, T9

*Although the M2 aid code is specified for Undocumented immigrants, this publication includes M2 in the ACA Expansion Adult – Ages 19 to 64 group. For this publication, this population was categorized using the following aid codes: 7U, L1, M1, M2, and P3.

Note: Aid category groupings were established by RASD and are used for analytical purposes only. They do not necessarily represent specific distinctions between eligibility criteria, funding sources, or any other differentiating characteristics.



Appendix 2

Table 2: Aid Codes by MAGI Status

MAGI Status Corresponding Primary Aid Codes MAGI 59, 5T, 7J*, 7K*, 8E, E2, E6, E7, M0, M1, M2, M3, M4, M5, M6, M7, M8,

M9, N5, N6, N7, N8, P0, P5, P6, P7, P8, P9, T0, T1, T2, T3, T4, T5, T6, T7, T8, T9

Non-MAGI 01, 02, 03, 04, 06, 07, 08, 0A, 0L, 0M, 0N, 0P, 0R, 0T, 0U, 0V, 0W, 0Y, 10, 13, 14, 16, 17, 1E, 1H, 1U, 1X, 1Y, 20, 23, 24, 26, 27, 2A, 2E, 2H, 2P, 2R, 2S, 2T, 2U, 2V, 30, 32, 33, 34, 35, 36, 37, 38, 39, 3A, 3C, 3D, 3E, 3F, 3G, 3H, 3L, 3M, 3N, 3P, 3R, 3T, 3U, 3V, 3W, 40, 42, 43, 44, 45, 46, 47, 48, 49, 4A, 4E, 4F, 4G, 4H, 4K, 4L, 4M, 4N, 4S, 4T, 4V, 4W, 53, 54, 55, 58, 5C, 5D, 5E, 5F, 5H, 5J, 5K, 5M, 5R, 5V, 5W, 60, 63, 64, 66, 67, 69, 6A, 6C, 6E, 6G, 6H, 6J, 6N, 6P, 6R, 6S, 6U, 6V, 6W, 6X, 6Y, 71, 72, 73, 74, 76, 77, 7A, 7C, 7F, 7G, 7H, 7M, 7N, 7P, 7R, 7S, 7T, 7U, 7W, 81, 82, 83, 86, 87, 8G, 8N, 8P, 8R, 8T, 8U, 8W, 8X, 90, C1, C2, C3, C5, C6, C7, C8, C9, D1, D2, D3, D4, D5, D6, D7, D8, D9, F1, F2, F3, F4, G1, G2, G3, G5, G6, G9, H0, H1, H2, H3, H4, H5, H6, H7, H8, H9, J3, J7, K1, L1, N0, N9, P1, P2, P3, P4, R1

*Aid codes 7J and 7K are both MAGI and Non-MAGI. For the purposes of analysis these aid codes have been included in the MAGI category only.

If You Plan To Cite this Paper in a Subsequent Work, We Suggest the Following Citation:

Research and Analytic Studies Division, September 2016. Medi-Cal Monthly Enrollment Fast Facts, June 2016. California Department of Health Care Services.

Legal Disclaimer:

Please note that this document provides a brief summary of complex subjects and should be used only as an overview and general guide to the Medi-Cal program. The views expressed herein do not necessarily reflect the policies or legal positions of the California Health and Human Services Agency (CHHS) and the California Department of Health Care Services (DHCS). These summaries do not render any legal, accounting, or other professional advice, nor are they intended to explain fully all of the provisions or exclusions of the relevant laws, regulations, and rulings of the Medicare and Medicaid programs. Original sources of authority should be researched and utilized.

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Medi-Cal Monthly enrollment fast facts - June 2016