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Revised May 20, 2014 Using MIS DSS Data
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Research and Analytic
Studies Division
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MEDI-CAL MONTHLY ENROLLMENT FAST FACTS Characteristics of the Medi-Cal population
as captured by the Medi-Cal Eligibility Data System
(MEDS)
January
2017
As of the MEDS Cut off
for April 2017
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. ! specific month’s enrollment count is considered
complete for statistical reporting purposes 12 months after the month’s end.
Please note that the values presented in figures included in this report may not add
up to 100% due to rounding.
January 2017 Certified Eligible Statistics – Medi-Cal Pop ulation
As of the MEDS Cut-off for April 2017
9,907,757
11,900,473 12,834,234
13,622,939
13,490,409
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
13,000,000
14,000,000
15,000,000
Cer
tifi
ed E
ligib
les
Month
Figure 1: Medi-Cal Certified Eligibles, January 2014 through January 2017
1,250,719
1,326,804
1,370,596
1,413,818
1,411,196
763,025
770,278
763,910
754,546
730,188
0
200,000
400,000
600,000
800,000
1,000,000
1,200,000
1,400,000
1,600,000
Cer
tifi
ed E
ligib
les
Month Dual Medi-Cal Only SPD
Figure 2: Medi-Cal Certified Eligibles – Dual Eligibles & Medi-Cal-Only Seniors and Persons with Disabilities (SPD), January 2014 through January 2017
Department of Health Care Services, Research and Analytic Studies Division 1
January 2017 Certified Eligible Statistics – Medi-Cal Pop ulation
As of the MEDS Cut-off for April 2017
Figure 3: Medi-Cal Certified Eligibles by Aid Category, January 2017*
54,129
162,161
139,486
651,857
1,304,022
1,998,289
3,827,940
5,352,525
- 2,000,000 4,000,000 6,000,000
Long-Term Care (LTC)**
Adoption/Foster Care
Other
Undocumented
CHIP
Seniors and Persons with Disabilities
ACA Expansion Adult – Ages 19 to 64
Parent/Caretaker Relative & Child
Certified Eligibles
Aid
Cat
ego
ry
40%
28%
15%
10%
5%
1%
1%
<1%
Figure 4: Gender, January 2017***
Male 6,264,171
46%
13,490,409
Female 7,226,238
54%
-
-
Figure 5: Age Group, January 2017****
65+ 1,127,561
8%
21 64 6,710,939
50% 13,490,409
0 20 5,651,909
42%
*Refer to the Appendix for detailed aid code groupings.
**Individuals residing in a LTC facility. ***One certified eligible without gender data was grouped in the “Female” gender cohort.
****Four certified eligibles without age data were grouped in the “0-20” age cohort.
Department of Health Care Services, Research and Analytic Studies Division 2
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January 2017 Certified Eligible Statistics – Medi-Cal Pop ulation
As of the MEDS Cut-off for April 2017
Figure 6: Race/Ethnicity, January 2017
American Indian/ Alaskan
Asian/ Pacific
Islander 1,758,727
13%
African American 1,017,124
8%
Hispanic 6,413,452
48%
Not Reported 1,581,878
12%
Native 55,712
<1%
White 2,663,516
20%13,490,409
Figure 7: Delivery System, January 2017
Fee for Service
2,705,518 20%
Managed Care
10,784,891 80%
13,490,409
Figure 8: Dual Status, January 2017
Dual 1,411,196
10%
Non-Dual 12,079,213
90%
13,490,409
Figure 9: ACA Expansion Adult - Ages 19 to 64 Aid Category, January 2017
ACA Expansion
Adult 3,827,940
28%
All Other Aid
Categories 9,662,469
72%
13,490,409
Department of Health Care Services, Research and Analytic Studies Division 3
January 2017 Certified Eligible Statistics – Medi-Cal Pop ulation
As of the MEDS Cut-off for April 2017
Figure 10: Language, January 2017
English 8,330,513
62%
Spanish 4,056,770
30%
Unknown 142,508
1%
Armenian 75,320
1%
All Chinese** 257,105
2%
Vietnamese 223,802
2%
All Other* 404,391
3%
Other 960,618
7%
Total = 13,490,409
*“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.”
Department of Health Care Services, Research and Analytic Studies Division 4
Figure 11: Medi-Cal Enrollees by Delivery System, January 2014 through
3,177,683
3,236,013
2,993,763
3,063,447
2,705,518
6,730,074
8,664,460 9,840,471
10,559,492
10,784,891
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
Cer
tifi
ed E
ligib
les
Month
Fee-for-Service Managed Care
Note: MAGI (Modified Adjusted Gross Income) is a methodology created under the ACA to calculate income eligibility for Medi-Cal. The MAGI eligibility rules apply to most people eligible for Medi-Cal, except the elderly or individuals who qualify based on a disability. Many certified eligibles in Non-MAGI aid codes are transitioned into MAGI aid codes during the redetermination process.
January 2017 Certified Eligible Statistics – Medi-Cal Pop ulation
As of the MEDS Cut-off for April 2017
Figure 1 2: Aid Category for Fee-for-Service Pa rticipants, January 2017
Department of Health Care Services, Research and Analytic Studies Division 5
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2,705,518
ACA Expansion
Adult Ages 19 to 64 760,671
28%
Adoption/ Foster Care
99,091 4%
CHIP 98,738
4%
LTC 26,244
1%
Other 126,258
5% Parent/
Caretaker Relative &
Child 522,449
19%
SPD 420,670
16%
Undocumented 651,397
24%
Figure 1 3: Aid Category for Managed Care Participants, January 2017
–
ACA Expansion
Adult Ages 19 to
64 3,067,269
28%
Adoption/ Foster Care
63,070 1%
CHIP 1,205,284
11%
LTC 27,885 <1%
Other 13,228 <1%
Parent/ Caretaker Relative &
Child 4,830,076
45%
SPD 1,577,619
15% Undoc-
umented 460
<1%
10,784,891
Figure 14: Medi-Cal Certified Eligibles, MAGI and Non-MAGI, January 2014 through January 2017
905,449
6,286,398
9,306,626
9,002,308 6,547,836
4,183,783
9,907,757
12,834,234 13,490,409
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 MAGI Non-MAGI Grand Total
Month
Cer
tifi
ed E
ligib
les
Note: MAGI (Modified Adjusted Gross Income) is a methodology created under the ACA to calculate income eligibility for Medi-Cal. The MAGI eligibility rules apply to most people eligible for Medi-Cal, except the elderly or individuals who qualify based on a disability. Many certified eligibles in Non-MAGI aid codes are transitioned into MAGI aid codes during the redetermination process.
January 2017 Certified Eligible Statistics – Medi-Cal Pop ulation
As of the MEDS Cut-off for April 2017
Figure 15: Medi-Cal Certified Eligibles by MAGI Status, January 2017
MAGI 9,306,626
69%
Non-MAGI 4,183,783
31%
13,490,409
Figure 16: Gender for MAGI, January 2017*
Male 4,359,138
47%
Female 4,947,488
53% 9,306,626
Figure 17: Gender for Non-MAGI, January 2017
Male 1,905,033
46%Female 2,278,750
54%
4,183,783
*One certified eligible categorized as MAGI and without gender data was grouped in the “Female” gender cohort.
Department of Health Care Services, Research and Analytic Studies Division 6
January 2017 Certified Eligible Statistics – Medi-Cal Pop ulation
As of the MEDS Cut-off for April 2017
Figure 18: Age G roup for MAGI, January 2017*
Department of Health Care Services, Research and Analytic Studies Division 7
-0 20 3,974,707
43%
21-64 5,325,556
57%
65+** 6,363 <1%
9,306,626
Figure 19: Age G roup for Non-MAGI, January 2017
--
0 20 1,677,202
40%
21 64 1,385,383
33%
65+ 1,121,198
27%
4,183,783
Figure 20: ACA Expansion Adult – Ages 19 to 64 Aid Category, January 2014 through January 2017
1,102,952
3,071,898
3,827,940
0
500,000
1,000,000
1,500,000
2,000,000
2,500,000
3,000,000
3,500,000
4,000,000
4,500,000
AC
A E
xpan
sio
n A
du
lts
Age
s 1
9-6
4
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.
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January 2017 Certified Eligible Statistics – Medi-Cal Pop ulation As of the MEDS Cut-off for April 2017
Figure 2 1: ACA Expansion Adult – Ages 19 to 64 Aid Category – Gender, January 2017*
Female 1,879,047
49%
Male 1,948,893
51% 3,827,940
Figure 22: ACA Expansion Adult – Ages 19 to 64 Aid Category – Age G roup, January 2017
0 20 283,174
7%
21-64 3,544,766
93%
3,827,940
Figure 23: ACA Expansion Adult – Ages 19 to 64 Aid Category– Race/Ethnicity, January 2017
Asian/Pacific Islander 656,212
17%
African-American 295,032
8%
Hispanic 1,473,600
39% White
966,566 25%
Not Reported 417,809
11%
3,827,940
Figure 24: ACA Expansion Adult – Ages 19 to 64 Aid Category– Delivery System, January
2017 American
Indian/Alaskan Native 18,721
<1% Fee for Service 760,671
20%
Managed Care
3,067,269 80%
3,827,940
*One certified eligible categorized as !C! Expansion !dult and without gender data was grouped in the “Female” gender cohort.
Department of Health Care Services, Research and Analytic Studies Division 8
January 2017 Certified Eligible Statistics – Medi-Cal Population As of the MEDS Cut-off for April 2017
Figure 25: ACA Expansion Adult – Ages 19 to 64 Aid Category – Aid Code, January 2017
32,313 1%
63,370 2%
3,366,921 88%
341,891 9%
23,445 1%
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 19to64, 0-138% FPL
P3-Hospital PE Adult, 0-138% FPL
Total = 3,827,940
Figure 26: ACA Expansion Adult – Ages 19 to 64 Aid Category – Language, January 2017
English 2,674,197
70%
Spanish 883,774
23%
Unknown 3,849 <1%
All Chinese** 83,414
2%
Korean 18,789
1%
Vietnamese 75,907
2%
All Other* 88,010
2% Other
266,120 7%
Total = 3,827,940
*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.”
Department of Health Care Services, Research and Analytic Studies Division 9
January 2017 Certified Eligible Statistics – Medi-Cal Pop ulation As of the MEDS Cut-off for April 2017
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, M2, 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.
Department of Health Care Services, Research and Analytic Studies Division 10
January 2017 Certified Eligible Statistics – Medi-Cal Pop ulation As of the MEDS Cut-off for April 2017
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, the Research and Analytic Studies Division
Suggests the Following Citation:
Research and Analytic Studies Division, May 2017. Medi-Cal Monthly Enrollment Fast Facts, January
2017. 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.
Department of Health Care Services, Research and Analytic Studies Division 11
