Announcement: DHCS EXPANDS MEDI-CAL YOUNG-ADULT ELIGIBILITY, RESTORES BENEFITS, ADDS CHILDHOOD-TRAUMA SCREENING IN 2020

DHCS EXPANDS MEDI-CAL YOUNG-ADULT ELIGIBILITY, RESTORES BENEFITS, ADDS CHILDHOOD-TRAUMA SCREENING IN 2020

SACRAMENTO – Medi-Cal, California’s health care program for low-income individuals and families, will extend full coverage to tens of thousands of additional young adults statewide effective January 1, 2020, another step toward building a California for All.

The young adult expansion, included in the 2019-2020 Budget signed by Governor Gavin Newsom, allows full-scope coverage for adults from age 19 until they turn 26, regardless of their documentation status, as long as they meet income and other eligibility requirements.  Previously, those Californians only could qualify for “limited scope” services, such as emergency medical care.

The expansion builds on California’s 2015 decision (SB 75, Chapter 18, Statutes of 2015) to cover all otherwise qualified children through age 18, regardless of documentation status, under Medi-Cal.  Those children have been eligible for full coverage since May 2016. 

“By extending coverage to age 26 we give young adults access to health care as they transition from school to work, in much the same way the Affordable Care Act allows young people covered by their parents’ private insurance to stay covered through their early 20s,” said Dr. Mark Ghaly, secretary of the California Health and Human Services Agency.  “This expansion is a key step toward creating a healthier California for all and helps more and more young Californians experience the benefits of primary care and preventative services.” 

DHCS estimates about 90,000 young adults statewide will gain access to full-scope Medi-Cal coverage in the first year as a result of the expansion.  About 75 percent of them are already enrolled to receive limited scope benefits.  The 2019-20 budget includes $98 million ($74.3 million from the General Fund) for the expansion.

“We’ve been working with our county partners for months to share information about the expansion and make sure the transition goes smoothly, as we did during the SB 75 implementation,” said Richard Figueroa, acting director of the California Department of Health Care Services (DHCS), which administers Medi-Cal.  “The young adult expansion will help to guarantee that California’s children who gained health care coverage under SB 75 don’t suddenly lose it on their 19th birthday.”

The New Year also will begin restoration of non-federally mandated “optional” health benefits that were cut from Medi-Cal during the last recession, including eyeglasses, audiology and speech therapy, podiatry, and incontinence creams and washes.  The budget includes $56.3 million ($17.4 million General Fund) to restore these optional benefits, which were cut in 2009.

January 1, 2020, also marks the effective date of ACEs Aware, a first-of-its-kind screening effort to identify childhood traumatic events that may lead to health problems, developed in partnership with California Surgeon General Dr. Nadine Burke Harris.  The Governor’s budget allocated $40.8 million to DHCS to screen children and adults covered by Medi-Cal for exposure to Adverse Childhood Events (ACEs).

Also effective January 1, 2020, DHCS will begin covering payments to encourage Medi-Cal providers to administer age-appropriate developmental screenings, to assess whether a child’s motor, language, cognitive, social, and emotional development are on track for their age.  The Governor’s budget allocated about $54 million in combined state and federal funds for the additional developmental screening payments.

For more information, contact:
Norman Williams
916- 440-7760
dhcs.ca.gov

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