SB 75 - Full Scope Medi-Cal for All Children Enrollment
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This dataset includes the monthly count of individuals under age 19 receiving full scope Medi-Cal benefits as authorized by California Welfare and Institutions Code 14007.8. The count reflects the total number eligible during the month. California provides full scope Medi-Cal benefits to all children under the age of 19 regardless of immigration status. This program is referred to as SB 75 and was implemented May 16, 2016 pursuant to SB 75 (Chapter 18, Statutes of 2015), Section 14007.8 and added to the Welfare and Institutions Code and amended by SB 4 (Chapter 709, Statutes of 2015).
Medi-Cal Enrollment by Eligibility Group
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This dataset includes the total number of individuals enrolled in Medi-Cal by eligibility group: Modified Adjusted Gross Income (MAGI), non-MAGI, and Children’s Health Insurance Program (CHIP). The groups are defined by the Centers for Medicare and Medicaid Services (CMS) Performance Indicators (CMSPI) reporting requirements. The Department of Health Care Services (DHCS) submits eligibility and enrollment data regarding Medicaid and CHIP monthly to CMS. The enrollment data represents enrollment totals as of 60 days after the eligibility month (indicated as “Reporting Period” in the dataset). CMS publishes the state total enrollments on the CMSPI website. The total enrollment comprises of individuals who are eligible for full scope Medi-Cal by MAGI – Child, MAGI – Adult, Non-MAGI Child, Non-MAGI Adult, and CHIP eligibility groups. DHCS does not report to CMS the total enrollment in limited scope Medi-Cal or state-only funded programs (indicated as the “Non-CMSPI” in the dataset).
Medi-Cal Adult Full Scope Expansion Programs
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This dataset contains data pertaining to the full scope expansion of the Adult Medi-Cal population, regardless of immigration status, within three (3) different age groups, each of the age groups is a result of different California legislation. The different age groups are identified below as well as the Senate or Assembly Bill citation for each. __Note:__ Counties with zero individuals enrolled during a reporting period are not included in the dataset. * __Age 19-25 Young Adult Expansion Population:__ The datasets include the monthly count of individuals ages 19 through 25, by county, receiving full scope Medi-Cal benefits. The counts reflect the total number of eligible individuals enrolled during the month. California provides full scope Medi-Cal benefits to young adults ages 19 through 25, regardless of immigration status. Lawfully present individuals ages 21 through 25, who are not in a pregnancy aid code, are included in this count. Individuals in the dataset are eligible for federal financial participation for their emergency and pregnancy-related services. The Young Adult Expansion program was implemented January 1, 2020, pursuant to [Senate Bill 104 (Chapter 67, Statutes of 2019)](https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201920200SB104), [California Welfare and Institutions Code Section 14007.8.](https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=WIC§ionNum=14007.8.) * __Age 26-49 Adult Expansion Population:__ The datasets include the monthly count of individuals 26-49 years of age, by county, receiving full scope Medi-Cal benefits. The counts reflect the total number of eligible individuals enrolled during the month. California provides full scope Medi-Cal benefits to adults 26-49 years of age, regardless of immigration status. Lawfully present individuals 26-49 years of age, who are not in a pregnancy aid code, are included in this count. Individuals in the dataset are eligible for federal financial participation for their emergency and pregnancy-related services. The Age 26-49 Adult Expansion program was implemented January 1, 2024, pursuant to [Senate Bill (SB) 184 (Chapter 47, Statutes of 2022)](https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=202120220SB184), [California Welfare and Institutions Code Section 14007.8.](https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=WIC§ionNum=14007.8.) * __Age 50 and over Older Adult Expansion Population:__ The datasets include the monthly count of individuals 50 years of age or older, by county, receiving full scope Medi-Cal benefits. The counts reflect the total number of eligible individuals enrolled during the month. California provides full scope Medi-Cal benefits to adults 50 years of age or older, regardless of immigration status. Lawfully present individuals 50 years of age or older, who are not in a pregnancy aid code, are included in this count. Individuals in the dataset are eligible for federal financial participation for their emergency and pregnancy-related services. The Older Adult Expansion program was implemented May 1, 2022, pursuant to [Assembly Bill (AB) 133 (Chapter 143, Statutes of 2021)](https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=202120220AB133), [California Welfare and Institutions Code Section 14007.8.](https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=WIC§ionNum=14007.8.)
Medi-Cal Enrollment by Eligibility Group
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This dataset includes the total number of individuals enrolled in Medi-Cal by eligibility group: Modified Adjusted Gross Income (MAGI), non-MAGI, and Children’s Health Insurance Program (CHIP). The groups are defined by the Centers for Medicare and Medicaid Services (CMS) Performance Indicators (CMSPI) reporting requirements. The Department of Health Care Services (DHCS) submits eligibility and enrollment data regarding Medicaid and CHIP monthly to CMS. The enrollment data represents enrollment totals as of 60 days after the eligibility month (indicated as “Reporting Period” in the dataset). CMS publishes the state total enrollments on the CMSPI website. The total enrollment comprises of individuals who are eligible for full scope Medi-Cal by MAGI – Child, MAGI – Adult, Non-MAGI Child, Non-MAGI Adult, and CHIP eligibility groups. DHCS does not report to CMS the total enrollment in limited scope Medi-Cal or state-only funded programs (indicated as the “Non-CMSPI” in the dataset).