|Budget Issue:||Examining the State and County Roles in the Optional Medi-Cal Expansion|
|Program:||Medi-Cal, State-Local Finance|
|Finding or Recommendation:||Adopt a state-based approach to the optional Medi-Cal expansion authorized under the federal Patient Protection and Affordable Care Act (ACA). Redirect a portion of the funding currently allocated to counties under 1991 realignment for indigent health to reflect the shift in responsibility for providing health care coverage to certain medically indigent adults from counties to the state.|
For more information about the optional Medi-Cal expansion under the ACA and its potential effect on the state-county fiscal relationship, please see our February 19, 2013 report, The 2013-14 Budget: Examining the State and County Roles in the Medi-Cal Expansion.