State of California & National Scene: Medicaid By State

California is one of 33 states that expanded its Medicaid program under the Affordable Care Act (ACA) to allow more low-income adults to sign up for coverage. So, how does California’s Medicaid program fare with the rest of the nation? Let’s take a look.

National Medicaid Statistics

More than 72 million Americans are enrolled in national Medicaid and Children’s Health Insurance Programs (CHIP) as of February 2019. Before the Affordable Care Act, only about 56.5 million Americans had access to health insurance. Now, one in five Americans is enrolled in Medicaid. Because of the program, more people than ever before have access to health insurance without the fear of being unable to afford their health care bills.

Top 10 States for Medicaid Spending

California is the number one state for Medicaid spending, according to the U.S. News & World Report. This is no surprise, as California has the largest Medicaid program in the nation, Medi-Cal. The top 10 states for Medicaid spending are:

1. California: $82 billion
2. New York: $62.9 billion
3. Texas: $40.3 billion
4. Pennsylvania: $27.6 billion
5. Florida: $21.8 billion
6. Ohio: $21.7 billion
7. Illinois: $19.3 billion
8. Massachusetts: $17.1 billion
9. Michigan: $16.9 billion
10. New Jersey: $14.5 billion

Top 10 States for Medicaid Enrollment

As states expanded access to Medicaid services, more people obtained health care services. The 10 top states with the highest percentage of their populations receiving Medicaid/CHIP services are:

1. Washington, D.C.: 38%
2. New Mexico:8%
3. Vermont: 3%
4. New York:9%
5. California: 1%
6. West Virginia:1%
7. Arkansas:2%
8. Delaware: 25%

Medicaid Program Variations by State

States determine their own standards for how to run the program, as long as they follow federal regulations, including who is eligible for services, what services can be covered by Medicaid and how hospitals and doctors will receive payments from Medicaid recipients, among other rules and requirements.

Because states have their own rules they determine eligibility and income requirements. In most state programs, pregnant women, children, seniors and disabled persons are almost always eligible for services. And generally, to be eligible for Medicaid your household income must fall below 138 percent of the federal poverty level (FPL).

A Look at Medicaid Programs in Calfornia’s Neighboring States

Similarly to California, five states expanded Medicaid access to include low-income adults also. Those states are Illinois, North Dakota, Ohio, Oregon and Pennsylvania. Many of California’s neighboring states also expanded access to their programs, including:

• Oregon: Oregon expanded access to low-income adults but also has programs for normal populations. The state also has medical marijuana and programs to help with substance drug and alcohol abuse.
• Nevada: Nevada expanded access for all households below the 138% FPL threshold.
• Washington: Washington grants access to adults with financial hardships regardless if they have children or other dependents. Income levels vary by household size.
• Arizona: Arizona expanded access to adults whose income levels make them ineligible for other programs, but they must earn less than 133% of the FPL. The program also offers low premiums and coinsurance rates for adults who earn more than 106% of the FPL.

California’s Medicaid Program: The Benefits of Medi-Cal

Before changes to the ACA, roughly 7 million Californians were enrolled in Medicaid — however, but since the expansion, roughly 12 million or one in three Californians are enrolled in Medi-Cal, the state’s Medicaid program. One of the greatest benefits to having the largest Medicaid program in the nation is expanding access to services that lead to a healthier overall population.

If you think you may be eligible for Medi-Cal services, get a quote from Health For California today. We’re here to make the application process simple and easy for you.