1. Merced county enrollment update
Medi-Cal and Covered California Enrollment During the First Phase of Coverage Expansion
Prepared by Pacific Health Consulting Group
July 24, 2014

2. TODAY’S DISCUSSION Uninsured prior to coverage expansion
Merced County enrollment outcomes and demographics in Medi-Cal and Covered California
Role of CEEs/CECs
Successes/Lessons Learned

3. MERCED COUNTY UNINSURED

4. COVERAGE ELIGIBILITY UNDER THE AFFORDABLE CARE ACT
An estimated 18,700 uninsured residents eligible for Medi-Cal (including 14,800 citizens)
81% of those eligible for Covered California also eligible for subsidies
Up to 17% of uninsured may be ineligible due to documentation status

5. MEDI-CAL ENROLLMENT (preliminary)
STATEWIDE
1.9M individuals enrolled into Medi-Cal
34% thru LIHP, 9% thru Express Lane Eligibility, 1% thru Hospital Presumptive Eligibility
900K applications pending approval as of June 2014
22% increase in Medi-Cal Managed care enrollment between Dec and May 2014
MERCED COUNTY
Central California Alliance for Health (CCAH) Merced enrollment increased by 20%, or 16,487 members, between Dec 2013 and June 2014
10,534 CCAH Adult Expansion members as of 6/14

6. MEDI-CAL ENROLLMENT (preliminary)
MERCED COUNTY
Compared to CA overall, more Medi-Cal expansion members entered thru Express Lane Enrollment and individual enrollment than thru LIHP
Open Enrollment appeared to spur enrollment by many previously eligible individuals as well - of the 6,113 new members that were NOT Adult Expansion aid codes, 39% were over age 18

7. MEDI-CAL ENROLLMENT (preliminary)
ADULT EXPANSION DEMOGRAPHICS - MERCED
44% aged 19-34
51% Hispanic/Latino, despite representing 70% of uninsured
Regional distribution similar to distribution of Merced uninsured

8. COVERED CALIFORNIA ENROLLMENT
Estimated 23,250 uninsured Merced residents eligible for Covered California, 81% eligible for subsidies
8,403 Merced residents enrolled in a Covered California Qualified Health Plan
Not known what % of enrollees would otherwise be uninsured
94% were subsidy eligible
41% Latino
Northern Merced over-represented in enrollment and Merced Metropolitan area under-represented in enrollment
Age distribution of enrollees similar to California overall

9. COVERED CALIFORNIA ENROLLMENT

10. COVERED CALIFORNIA ENROLLMENT

11. CERTIFIED ENROLLMENT COUNSELORS
2,356 completed Covered CA enrollments in Merced supported by CECs
Higher % of Covered CA enrollments in Merced supported by CECs than in CA overall (28% vs. 9%)
Top four CEEs in Merced completed two Medi-Cal enrollments for every one Covered CA enrollment – similar to CA overall
Top two CEEs in Merced completed over 1,200 Covered CA enrollments – 5 other Merced CEEs completed 100 or more enrollments

12. CERTIFIED ENROLLMENT COUNSELORS
FEEDBACK FROM MERCED CEEs
Common Target Populations: Latinos, African-Americans, SE Asians, mixed immigration status families, Limited English Proficiency individuals
Most Difficult to Engage: Young adults, mixed immigration status families, rural communities
Most Successful Strategies: In-Reach, trusted messenger, media, outreach, multi-agency events (TV, radio most effective media)
Medi-Cal Outreach: Most CEEs continued Medi-Cal education/outreach after Open Enrollment, but only half continued enrollment support

13. PRELIMINARY TAKE-AWAYS
Medi-Cal outreach and enrollment appeared to be extremely successful
More than 10K newly eligible adults and likely several thousand previously eligible children/adults enrolled
W/out a large LIHP population, there was a CECs and HSA played a significant enrollment role
Covered California enrollment efforts were not as successful
Individuals 138%-400% FPL were 81% of eligible individuals, they represented 94% of enrollments
Although it is unknown how many new enrollees were previously uninsured, it is likely that more than 2/3 of eligible uninsured residents enrolled

14. PRELIMINARY TAKE-AWAYS
Latino enrollment was low in both Covered California and Medi-Cal compared to their proportion of eligible uninsured
For the most part, Covered California and Medi-Cal enrollment was distributed between regions similar to the distribution of uninsured
The age distribution of Covered California enrollees was similar to California overall

15. NEXT STEPS
Incorporate data from HSA on total Medi-Cal enrollment, MAP transitions and pending applications
Develop report brief for distribution