AI Is Being Used to Boost Medicaid Enrollment, but Not Without Concerns

In Kern County, California, the majority of residents rely on Medicaid, known as Medi-Cal, for health coverage, with an estimated 52% of the population dependent on the safety net program. To ensure continued coverage, many individuals must renew their enrollment, a process that is becoming more complex due to new eligibility rules set by the GOP's One Big Beautiful Bill Act, signed into law by President Donald Trump.

Kern Family Health Care, the largest Medi-Cal provider in the county, has adopted an AI program named "Angelica" to streamline the renewal process, saving the health plan significant costs and resources. Angelica facilitates communication in members' preferred languages, schedules appointments, and ensures accurate application submission to county health officials for verification and processing.

Despite concerns about AI-driven job losses and algorithmic biases, Kern Family officials assert that no workers have lost their jobs, attributing the cost savings to the program's efficiency. However, health policy researchers and unions have raised concerns about potential misuse of such technology, such as cherry-picking patients for coverage and compromising patient privacy.

State regulators and the attorney general's office are closely monitoring AI use in healthcare, but managed care plans like Kern Family Health Care are responsible for ensuring compliance with state and federal regulations.