California's "Bridge to Reform" Medicaid Demonstration Waiver

This issue brief provides an overview of California’s “Bridge to Reform” Medicaid Demonstration Waiver, which was approved in 2010 and will make up to roughly $8 billion in federal Medicaid matching funds available to California over a five-year period to expand coverage to low-income uninsured adults and preserve and improve the county-based safety-net. The waiver also allows the state to enroll Medicaid-eligible seniors and persons with disabilities into managed care plans that meet specified readiness and network adequacy requirements. Enrollment in the coverage expansion is targeted to begin on a county-by-county basis on July 1, 2011 and the transition of seniors and people with disabilities into managed care plans was scheduled to start on June 1, 2011.

The California waiver may serve as a model for other states to use Section 1115 Medicaid demonstration waivers to facilitate the transition to health reform in 2014. Operational experience from the waiver could help to inform implementation of the ACA by other states, safety net providers, and the federal government. A related fact sheet on the California waiver is also available.

Fact Sheet (.pdf)

Issue Brief (.pdf)