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San Francisco reports strong ACA enrollment gains; Healthy San Francisco rolls down as Medi-Cal and Covered California expand
Summary
San Francisco Department of Public Health staff told the commission that San Francisco saw about 56,000 new MAGI Medi-Cal enrollees and roughly 41,000 Covered California enrollees in 2014; Healthy San Francisco enrollment has declined to about 16,000 as residents transition to ACA coverage, and county-level renewal data remain limited.
Annika Chowdhury of the Department of Public Health's Office of Policy and Planning told the Health Commission on April 22 that San Francisco matched and in some places exceeded statewide gains from the Affordable Care Act enrollment period.
"In San Francisco we had about 56,000 people enroll in Medi-Cal expanded coverage, and another 41,000 people enrolled in Covered California plans in San Francisco," Chowdhury said, summarizing 2014 enrollment and early 2015 new-enrollee counts.
Chowdhury said statewide enrollment exceeded 4 million people in the ACA's first year and that Medi-Cal statewide added roughly 2.7 million people. In San Francisco, the Healthy San Francisco program'which previously covered many uninsured residents'has declined by about 60% and had about 16,000 enrollees as of March.
She cautioned that county-level renewal and churn data were not yet available from Covered California; the department is waiting for more detailed state releases to measure how many former Healthy San Francisco participants moved into Medi-Cal, Covered California plans or employer coverage.
Commissioners asked for follow-up details on the remaining uninsured population in San Francisco and churn among Healthy San Francisco enrollees. Director Garcia said county-level detail should be available later in the year and staff would return with data for commission review.
Why it matters: the city's enrollment numbers indicate major gains in coverage that could change service demand patterns across public clinics and the San Francisco Health Network. Commissioners said they will monitor renewals and transitions to determine whether access, continuity of care and Health Network participation are affected.
Next steps: department staff will seek county-level renewal and churn data, report on how many Healthy San Francisco participants stayed with SFHN providers or moved to other plans, and present additional analysis to committees over the next six months.
