The California Department of Health Care Services (DHCS) and California counties achieved an important milestone in California’s “Bridge to Reform” demonstration waiver on June 1 when 16 California counties began enrolling Medi-Cal recipients in managed care organizations. California’s “Bridge to Reform” demonstration waiver was approved by the Centers for Medicare and Medicaid Services (CMS) in November 2010 as a multi-faceted, $10 billion strategy to reform Medi-Cal in preparation for full implementation of the Affordable Care Act (ACA) in 2014. DHCS committed California under a key provision of this “section 1115” demonstration waiver to establish a “seniors and persons with disabilities” (SPD) program under which such individuals (subject to appropriate exceptions) would be enrolled in managed care plans that meet safeguards as to network readiness, access, and quality of care, helping to effectively control costs and improve quality of care for this often vulnerable, high cost population. California now has met the aggressive June 1 timeline that it negotiated with CMS last year. Approximately 380,000 California seniors and disabled persons will be enrolled in managed care in monthly increments over the next 12 months.