The Medi-Cal 2030 Coalition is comprised of the leading voices for a person-centered, accountable, and sustainable state Medicaid program. Our organizations represent the people who depend on Medi-Cal not only as a health care program, but also as an economic safety net. We are united by the idea that Medi-Cal is foundational to the future of California and that getting it right requires a laser focus on the people whose lives are most impacted by its success. Both Governor Newsom and California’s next Governor have an opportunity to transform the program into one that truly works for consumers by 2030.
Background
Medi-Cal is California’s single largest health care program and one of the most consequential public investments in the state’s history. Medi-Cal is not a peripheral safety net; it is the primary source of health coverage for low-income families, children, seniors, people with disabilities, and immigrant communities across every county in California. It covers almost half of all births in the state and serves as an essential economic stabilizer helping to keep Californians out of poverty. And yet, despite this scale, Medi-Cal has never fully lived up to its promise of equitable care for all.
Decades of research document persistent and preventable disparities in coverage, access, quality, and health outcomes along lines of race, ethnicity, income, language, immigration status, disability, and geography. These are not individual failings but are the product of structural racism and systemic inequities embedded within health care policy, financing, and delivery that Medicaid, by design, must confront.
As we navigate the largest disinvestment in public health care services in history and consider the future of Medi-Cal, reform requires more than incremental adjustments; it demands a shared framework of purpose. When a program as complex and consequential as Medi-Cal lacks explicit, equity-centered principles, resources can be misaligned, reforms can be fragmented, and the communities most in need can be left behind, even as spending grows.
Join Us
Transforming Medi-Cal will require a diverse and powerful coalition. We invite you to join us by endorsing the Medi-Cal 2030 Principles. Please complete this form to be added to the coalition and receive future actions and opportunities.
A Person-Centered Program
The primary goal of Medi-Cal is to ensure access to health care for every Californian so they may have a decent quality of life regardless of their ability to pay. Medi-Cal must recognize and be intentionally designed to address the unique health care challenges faced by those living in poverty, older adults, children, and people with disabilities, people of color, immigrants, limited-English proficient people, and LGBTQIA+ people.
All Californians deserve health and health care. Immigration status must not serve as an exclusion from Medi-Cal. Eligibility determinations and processes must be designed to make coverage easier to get and keep.
Medi-Cal members must not face discriminatory barriers to health and care, including lack of access to evidence-based treatments, physically inaccessible health care facilities, lack of translation and interpretation services, unlawful discrimination, and cost-sharing requirements. These barriers undermine the program’s core mission.
Medi-Cal must provide medically appropriate and comprehensive health care services that meet the needs of people across their lifespan. This must include the full scope of Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) services for children, robust and equitable long-term services and supports that enable full participation in community life for older adults and people with disabilities, and sexual and reproductive health services including family planning, contraception, abortion, and gender affirming care.
An Accountable Program
No person or corporation should excessively profit from Medi-Cal participation. Every dollar should contribute to the health and welfare of Medi-Cal members and be reinvested in the communities most impacted by poverty.
Medi-Cal should be governed by and accountable to those it serves. Governance structures should ensure that those served by the program have real decision-making power over how resources are spent and services are delivered.
Data collection, metrics and measurements should be aligned with the needs and priorities of members and other decision makers and should correspond directly to accountability, with meaningful incentives and penalties attached. Metrics should also capture and create accountability for reducing and eliminating racial and ethnic health inequities.
As an entitlement program, Medi-Cal must include important rights and protections under the law for its members. The rights must be accounted for, realized and enforced. Medi-Cal members should be treated with dignity and respect, provided with timely and culturally and linguistically appropriate care, and have access to resources to address concerns.
A Sustainable Program
A strengthened, consumer-centered Medicaid program should move toward a unified health care delivery system in which a consumer’s source of coverage is invisible at the point of care and not determine their access, quality of care, or health outcomes. Consumers should have choice in providers and access to substantially similar provider networks in Medi-Cal as in other health coverage.
California must insulate Medi-Cal against state and federal policy and budget cuts by addressing the need for additional state revenue and containing excessive, profit-driven health care cost growth.
Medi-Cal is only as strong as the workforce that delivers its care. There is no replacement for human connection in health care. California must ensure that Medi-Cal members have access to a sufficient, stable, and culturally concordant workforce – a workforce that reflects the diversity of the communities it serves and is fairly compensated for the essential work it provides.