Publication Date

Fall 12-2019

Degree Type

Master's Project

Degree Name

Master of Public Administration (MPA)


Public Administration

First Advisor

Frances Edwards


This research identified the factors that contributed to the decline of Medi-Cal enrollment in the County of Santa Clara (CSC). Additionally, it determined the actions that the County of Santa Clara Health System (CSCHS) can adopt to mitigate such decline. The CSCHS is the local safety-net healthcare provider for the residents of the CSC. Despite the CSCHS experiencing a significant increase in Medi-Cal covered individuals with the implementation of the Affordable Care Act (ACA) in 2010, this trend has overturned by 2019, with the County witnessing a significant decrease in Medi-Cal enrollment rates.