Obamacare brings expanded coverage and higher costs to California

Workers help applicants register for Medi-Cal in Richmond, Calif.
(Justin Sullivan / Getty Images)

Enrollment in California’s healthcare program for the poor has soared as the state implements President Obama’s federal overhaul, pleasing advocates who have sought expanded coverage but also presenting new costs for the state.

Nearly one-third of California’s total population -- roughly 11.5 million people -- will be enrolled in Medi-Cal next year, according to Gov. Jerry Brown’s administration.

Enrollment is expected to exceed previous estimates by 1.4 million, and administration officials said it would cost the state $1.2 billion more than originally thought.


While unveiling his newest budget proposal on Tuesday morning, Brown said expanded healthcare coverage represented “a huge social commitment on the part of the taxpayers of California.”

“I’m proud we did it,” he said. “But we also have to take into account this thing is growing.”

Although the federal government picks up the tab for any patients who became eligible for Medi-Cal under the Affordable Care Act, the state is still responsible for half the price for people who were previously eligible but hadn’t yet signed up.

The latter group is now expected to grow 60% more than state officials originally projected, driving up California’s share of the costs.

Diana Dooley, the top official overseeing healthcare in Brown’s administration, described it as the “woodworking effect.” With all the publicity surrounding Obamacare, she said, people “came out of the woodwork” to sign up for Medi-Cal.

“The outreach was successful and people responded,” she said Tuesday.


Although advocates have cheered the expansion of healthcare coverage, they are concerned that Brown won’t increase payments to doctors who participate in Medi-Cal. The governor cut rates by 10% during the state’s budget crises.

“It doesn’t make sense to continue those recession-era cuts,” said Anthony Wright, executive director of Health Access. “If you’re introducing a couple more million people into the program, there needs to be an investment.”