Low-income Californians' experiences with health insurance and managed care

California is rapidly implementing mandatory managed care for most of its M edicaid (Medi-Cal) beneficiaries. To assess the impact of this delivery sys tem change, the authors analyzed a 1996 statewide population-based random-s ample telephone survey of 3,563 adults between the ages of 18 and 64. Respo ndents with Medi-Cal managed care and Medi-Cal-fee-for-service rated access to care and quality of care significantly higher than uninsured respondent s yet lower than low-income privately insured individuals. While the author s did not find a difference in health care access and quality among Medi-Ca l managed care enrollees compared with Medi-Cal fee-for-service enrollees, they also did not find that managed care provided any observed advantages t o Medi-Cal recipients.