Coverage Initiative


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About the Health Care Coverage Initiative


California's Health Care Coverage Initiative (HCCI) program began on September 1, 2007. HCCI extended health care coverage to more than 230,000 low-income uninsured adults who were not otherwise eligible for public programs such as Medi-Cal. Ten counties participated in the HCCI program: Alameda, Contra Costa, Kern, Los Angeles, Orange, San Diego, San Francisco, San Mateo, Santa Clara, and Ventura.

The HCCI program was authorized under California's 2005 §1115 waiver (No. 11-W-00193/9).

The HCCI program was initially scheduled to end on August 31, 2010. However, in November 2010, California received approval to implement the Low Income Health Program (LIHP), which effectively extended and expanded HCCI into a new statewide program that runs through 2014. HCCI enrollees continued to receive coverage, and transitioned to LIHP in July 2011.

Visit DHCS' Health Care Coverage Initiative website.


A central concept of the HCCI program was to shift low-income uninsured individuals from more costly episodic care to a more coordinated system of care, thereby improving access to care, quality of care, and overall health. Therefore, a fundamental feature of the HCCI program was the assignment of individuals to a medical home.

The specific goals of the program were to:

  • Expand the number of Californians who have health care coverage;
  • Strengthen and build upon the local health care safety net system, including disproportionate share hospitals, county clinics, and community clinics;
  • Improve access to high quality health care and health outcomes for individuals;
  • Create efficiencies in the delivery of health services that could lead to savings in health care costs;
  • Provide grounds for long-term sustainability of the programs funded under the initiative; and
  • Implement programs in an expeditious manner in order to meet federal requirements regarding the timing of expenditures.

Eligibility and Program Design

The basic eligibility criteria for the program were defined in the authorizing §1115 Medicaid waiver. In order to be eligible for HCCI program participation, individuals had to be:

  • a resident of the participating county,
  • adult ages 19-64,
  • income below 200% of the federal poverty level,
  • currently uninsured and with no insurance in the previous three months,
  • not eligible for other insurance coverage including Medi-Cal or Healthy Families, and,
  • U.S. Citizen or Legal Permanent Resident with at least 5 years residence in the U.S.

Participating counties were allowed to set additional eligibility restrictions beyond these parameters. Read more about the implementation of HCCI in each of the ten demonstration counties.

Learn more about the program design.

HCCI Evaluation

An evaluation of the HCCI program was required by the authorizing waiver and legislation. The evaluation was designed to measure the success of the program in meeting the program goals. Read more about the HCCI Evaluation