The major provisions of the federal health care reform law – the Affordable Care Act (ACA) – including the expansion of coverage to the uninsured, start in 2014. In the meantime, the feds have provided states with the ways and means to get an early start on providing coverage for some uninsured people using the Medicaid 1115 Waiver process. California applied and received approval to expand coverage to uninsured legal residents under 65 with incomes between 0-200 percent of the federally defined poverty level (FPL). With the help of federal matching funds, this coverage would be provided by counties until 2014 when the 0-133 percent of FPL population converts to Medi-Cal and the 134-200 percent of FPL population converts to subsidized health coverage purchased through the state Exchange.

This report describes the major provisions of this Waiver with a focus on Southern California counties.