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This is a Non-Federal dataset covered by different Terms of Use than Data.gov.

Insurance Affordability Programs Eligibility Appeals

Metadata Updated: March 23, 2026

This dataset includes the number of individuals who have filed an appeal for a subsidized Covered California Qualified Health Plan (QHP), Medi-Cal, or a combination of both eligibility determinations by year and quarter. Appeals may be filed by an appellant for determinations that resulted in a denial, eligibility, or discontinuance of coverage. A denial is defined as an eligibility determination at application that resulted in a denial of coverage. An appeal regarding an eligibility determination may be filed when the appellant disputes the type of program eligibility. A discontinuance is when an individual is no longer eligible for Medi-Cal or Covered California QHP. Appeals may be filed for cases involving mixed determinations, such as when household members applied for and/or had eligibility determinations made for the two programs (i.e., parents were eligible for Covered California and the child(ren) were eligible for Medi-Cal). Covered California and Medi-Cal eligibility appeals are processed and adjudicated by Administrative Law Judges and the California Department of Social Services (CDSS) staff who track appeals and hearing results. This dataset is part of the public reporting requirements set forth in California Welfare and Institutions Code 14102.5(a)(6).

Access & Use Information

Public: This dataset is intended for public access and use. Non-Federal: This dataset is covered by different Terms of Use than Data.gov. License: See this page for license information.

Downloads & Resources

Dates

Metadata Created Date November 11, 2023
Metadata Updated Date March 23, 2026

Metadata Source

Harvested from State of California

Additional Metadata

Resource Type Dataset
Metadata Created Date November 11, 2023
Metadata Updated Date March 23, 2026
Publisher California Department of Health Care Services
Maintainer
Identifier 0b1be039-21cf-447f-9c53-88610dfbf99d
Data First Published 2017-06-16T22:17:25.454433
Data Last Modified 2026-03-16T17:15:47.737722
Category Health and Human Services
Public Access Level public
Metadata Context https://project-open-data.cio.gov/v1.1/schema/catalog.jsonld
Schema Version https://project-open-data.cio.gov/v1.1/schema
Catalog Describedby https://project-open-data.cio.gov/v1.1/schema/catalog.json
Harvest Object Id d9bd36cd-a9fe-4cc7-b566-e10cf0223a42
Harvest Source Id 3ba8a0c1-5dc2-4897-940f-81922d3cf8bc
Harvest Source Title State of California
License http://www.opendefinition.org/licenses/cc-by
Source Datajson Identifier True
Source Hash 679f1c2cf3721e9d5d4d5410c2e9792e7ca97e25a842b7f1df559c07331e36ab
Source Schema Version 1.1

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