For the next four years, California's public hospitals will collectively receive up to $472 million annually to cover hospital visits for the uninsured as part of a waiver meant to reform the state's Medicaid program.
State officials were informed earlier this month of the decision, which had seemed unlikely since the CMS had been reluctant to pay for the uninsured now that the Affordable Care Act has provided coverage to more Americans.
California had to make its case for keeping the funding. In 2014, the state expanded Medicaid to people who made 138% of the federal poverty level. That covered an additional 3 million people.
But an independent analysis found that at almost 4 million people, California has the second-largest uninsured population in the U.S.
The group comprises people who may be eligible for Medicaid but don't know it, which includes undocumented immigrants and those who can't afford marketplace coverage, even with subsidies.