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THE CALIFORNIA Journal of Politics & Policy Volume 3, Issue 4 The California Challenge: Ensuring Primary Care Access for Medi-Cal Recipients under the Affordable Care Act Donald A. Barr Stanford University Abstract This paper describes options for expanding access to care for California’s Medi- Cal population. Recent federal policy initiatives and an expanding set of research reports have begun to focus considerable attention on developing new models for the organization of primary care services. Initial results suggest that these innova- tive delivery models can both decrease the overall cost of care while improving the quality of care. This conclusion is especially relevant for those who provide care to Medi-Cal recipients with chronic medical conditions—the population that con- tributes by far the most to the cost of Medi-Cal. The exigencies of containing both federal and state health care expenditures for all covered populations make consid- eration of alternative modes of health care delivery an essential part of any analysis of the potential impacts of ACA, both in California and throughout the country. Keywords: medical care, Affordable Care Act, Medi-Cal, Medicaid Copyright © 2011 The Berkeley Electronic Press. All rights reserved. www.bepress.com/cjpp