To understand the strategies that states undertake to expand coverage and initiate broader health reform, it is important to recognize the variability in states’ health coverage distribution, employer-sponsored insurance rates, and public program eligibility levels. The charts below highlight certain aspects of California's coverage landscape.
For more information on specific coverage programs implemented in this state, please click on the ‘Coverage Strategies’ tab.
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Group
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Income Eligibility
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200% FPL (ages 0-1)
133% FPL (ages 1-5)
100% FPL (ages 6-19)
250% FPL (SCHIP)
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Pregnant Women[4]
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300% FPL
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Parents[5]
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100%/200% FPL
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Adults[6]
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200% FPL
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SSI Disabled (non-elderly)
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102% FPL
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Sources of Health Insurance Coverage State Data 2006 – 2007, U.S.[7]
Percentage of Private-Sector Establishments That Offer Health Insurance Based on Firm Size by State, 2006[8]
[1] This overview provides a general description of state coverage levels under their Medicaid and SCHIP programs, including coverage through waivers, as of February 2008. The Center for Health Program Development and Management researched eligibility information from CMS and state web sites, data from state reports, and verified through contacts with CMS and state officials during the winter of 2008. This does not reflect the specific eligibility categories or requirements. This is not intended to be a substitute for eligibility information provided by each state. Individuals interested in applying for these programs should contact the state directly for specific eligibility requirements.
[2]Medicaid eligibility based on children’s family income levels is listed by age group. For states with additional SCHIP eligibility for higher income levels, SCHIP income level eligibility information is presented separately.
[3] Children (19 and younger) whose income is up to 300 percent of the FPL are covered in three counties: San Francisco, San Mateo, and Santa Clara. These three counties draw federal matching funds via the C-CHIP program. San Mateo covers children from 300 to 400 percent of the FPL using county funds. Alameda County has authority to draw federal matching for uninsured children under 300 percent of the FPL but has not implemented.
[4] Medi-Cal covers pregnant women up to 200 percent of the FPL. The Access for Infants and Mothers (AIM) program now draws Title XXI federal matching funds for uninsured pregnant women from 200 to 300 percent of the FPL.
[5] Qualified uninsured parents with income at or below 200 percent of the FPL may receive benefits through the Coverage Initiative under California’s Medi-Cal Hospital Uninsured Care section 1115 waiver program. Qualified parents are covered under traditional Medicaid up to 100 percent of the FPL.
[6] All qualified uninsured adults in selected counties with income at or below 200 percent of the FPL may receive benefits through the Coverage Initiative under California’s Medi-Cal Hospital Uninsured Care section 1115 demonstration.
[7] Urban Institute and Kaiser Commission on Medicaid and the Uninsured estimates based on the Census Bureau’s March 2007 and 2008 Current Population Survey.
[8] Agency for Healthcare Research and Quality, Center for Financing, Access and Cost Trends. 2006 Medical Expenditure Panel Survey-Insurance Component.
State Profiles
