Publication Date

Fall 2019

Degree Type

Master's Project

Degree Name

Master of Public Administration (MPA)


Urban and Regional Planning

First Advisor

Frances Edwards


Medi-Cal, County of Santa Clara (CSC), County of Santa Clara Health System (CSCHS), public health insurance, public health


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.