Coverage Initiative


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About the Low Income Health Program


The Low-Income Health Program (LIHP) -- also known as California’s “Bridge to Reform” -- was a county-based program that offered health care coverage to low-income adults in the years immediately preceding the implementation of health care reform. The goal of LIHP 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. Nearly 500,000 Californians ultimately participated in LIHP.

LIHP built upon the previous Health Care Coverage Initiative (HCCI) program, to provide a statewide expansion of health care coverage to eligible, low-income adults. Implementation of the LIHP demonstration was phased in beginning November 1, 2010.

LIHP was a county-based elective program consisting of two components distinguished by enrollee income level:

  • LIHP-Medicaid Expansion (LIHP-MCE) (0-133% of FPL) and 
  • LIHP-Health Care Coverage Initiative (LIHP-HCCI) (134-200% of FPL).

The program ended December 31, 2013, at which time enrollees transitioned into the Medi-Cal program or the California health benefit exchange Covered California under the federal health care reform legislation, the Affordable Care Act.

Counties that elected to participate in LIHP were required to implement programs meeting specific guidelines and standards, including establishing an adequate provider network, assigning enrollees to a medical home, and providing a minimum array of medical and behavioral health services. A broader range of medical services was required within the LIHP-MCE component than LIHP-HCCI component.

LIHP was funded jointly by local and federal dollars: counties participating in the program were eligible to recieve federal reimbursement funds for approximately 50% of their costs for providing care to enrolled participants. Unlimited federal reimbursement funds were available for the LIHP-MCE program; up to $630 million was available to be distributed among the counties participating in the LIHP-HCCI component of the program.

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