An Unfulfilled Promise for Communities of Color
In 2014, California’s Medi-Cal program significantly strengthened access to mental health services. As a result of the Affordable Care Act, eligibility for Medi-Cal was expanded to adults in families with incomes below 138% of the federal poverty limit. By 2016, over 13 million Californians were enrolled in Medi-Cal. Along with the coverage expansion, California expanded the scope of its Medi-Cal mental health coverage to include a more comprehensive spectrum of services. Newly eligible adults, a majority of whom were people of color, often had significant unaddressed mental health needs due to years of lack of access to health care coupled with living in or near poverty. As a result of the expansion, Californians with low incomes were more likely than before to have coverage for mental health services through Medi-Cal.vi
Despite these gains, access to mental health services in Medi-Cal still remains out of reach for many. This report analyzes the extent to which people of color access non-specialty Medi-Cal mental health services, why gaps remain, and what can be done to fulfill the promise of comprehensive mental health care for all Californians. This report focuses on understanding the barriers to care for adults. Children in the Medi-Cal program also face significant unmet mental health needs. Additional research and policy work is necessary to reckon with and address the gaps specific to children.