Applications Received For Insurance Affordability Programs Through Other Eligibility Pathways

The number of Insurance Affordability Programs (IAPs) applications received through other eligibility pathways. Other eligibility pathways include applications transferred through transition from Advanced Premium Tax Credits (APTC) to Medi-Cal, as well as applications submitted through Hospital Presumptive Eligibility (HPE), through Express Lane, or the Medi-Cal Access Program (MCAP) during a reporting period. APTC to Medi-Cal batch data is reported by CalHEERS and MEDS and consists of individuals who are no longer eligible for APTC but are eligible for Medi-Cal. Another eligibility pathway is Express Lane Eligibility (ELE), which is a program that waives the need for a Medi-Cal eligibility determination for 12 months if the individual is enrolled in CalFresh. Hospital Presumptive Eligibility (HPE) applications are submitted through qualified HPE Providers. ELE and HPE data are reported by DHCS and commencing with this report, MCAP applications are reported by MAXIMUS Inc. This dataset is part of public reporting requirements of set forth in the California Welfare and Institutions Code 14102.5.

Data and Resources

Field Value
accessLevel public
catalog_@context https://project-open-data.cio.gov/v1.1/schema/catalog.jsonld
catalog_conformsTo https://project-open-data.cio.gov/v1.1/schema
catalog_describedBy https://project-open-data.cio.gov/v1.1/schema/catalog.json
identifier 66270993-2a34-4fe4-b19f-eb06f1c75d88
issued 2018-01-03T22:47:33.714452
modified 2022-06-13T18:06:12.547517
publisher California Department of Health Care Services
resource-type Dataset
source_datajson_identifier true
source_hash 6a1ec59610eb24ab6d2e741c5e2a36f5ded361d4
source_schema_version 1.1
theme {"Health and Human Services"}
Groups
  • AmeriGEOSS
  • National Provider
  • North America
Tags
  • abx
  • abx1-1
  • advanced-premium-tax-credits-aptc
  • amerigeo
  • amerigeoss
  • applications
  • california-department-of-health-care-services
  • california-eligibility-and-enrollment-report
  • ckan
  • covered-ca-qhp-eligibility
  • covered-california
  • dhcs
  • ele
  • express-lane
  • geo
  • geoss
  • hospital-presumptive-eligibility
  • hpe
  • insurance-affordability
  • medi-cal
  • medi-cal-applications
  • medi-cal-eligibility
  • national
  • north-america
  • qup
  • united-states
isopen False
license_id notspecified
license_title License not specified
maintainer Medi-Cal Eligibility Division / Program Review Branch / Data Analytics Section
maintainer_email opendata@dhcs.ca.gov
metadata_created 2025-11-20T19:22:05.607200
metadata_modified 2025-11-20T19:22:05.607205
notes The number of Insurance Affordability Programs (IAPs) applications received through other eligibility pathways. Other eligibility pathways include applications transferred through transition from Advanced Premium Tax Credits (APTC) to Medi-Cal, as well as applications submitted through Hospital Presumptive Eligibility (HPE), through Express Lane, or the Medi-Cal Access Program (MCAP) during a reporting period. APTC to Medi-Cal batch data is reported by CalHEERS and MEDS and consists of individuals who are no longer eligible for APTC but are eligible for Medi-Cal. Another eligibility pathway is Express Lane Eligibility (ELE), which is a program that waives the need for a Medi-Cal eligibility determination for 12 months if the individual is enrolled in CalFresh. Hospital Presumptive Eligibility (HPE) applications are submitted through qualified HPE Providers. ELE and HPE data are reported by DHCS and commencing with this report, MCAP applications are reported by MAXIMUS Inc. This dataset is part of public reporting requirements of set forth in the California Welfare and Institutions Code 14102.5.
num_resources 2
num_tags 26
title Applications Received For Insurance Affordability Programs Through Other Eligibility Pathways