Child Health Plans Hailed, but More Publicity Urged

With reforms enacted last year, California has an unprecedented opportunity to fill gaping holes in children’s health insurance coverage--but the state must do a far better job reaching out to families, especially the working poor, according to a UCLA report being released today.

Medi-Cal expansion and the new Healthy Families program have the potential to insure two-thirds of the state’s 1.7 million children currently without coverage, yet substantial obstacles may prevent families from taking advantage of their youngsters’ eligibility, according to the policy brief by UCLA’s Center for Health Policy Research.

The programs have “tremendous potential to go a long way toward helping to solve problems for the uninsured, but there are things we need to do” to make them work, said E. Richard Brown, lead author of the brief.

Even under the best of circumstances, the new initiatives will leave nearly half a million children and almost 5 million adults without insurance, the researchers said. Neither Medi-Cal--serving California’s poorest residents--nor the state Healthy Families program will help youngsters whose family income is above 200% of the poverty level. Healthy Families does not cover adults.

State officials say that the concerns expressed in the report are legitimate but that many of them are already being addressed.

An estimated 562,000 children will become eligible starting July 1 for low-cost health insurance through Healthy Families. The program was created last year to aid families of low-income workers who do not qualify for Medi-Cal but who cannot afford coverage on their own. For monthly premiums as low as $7 and co-payments of $5 for most services, Healthy Families will offer benefits ranging from dental care to physical therapy.

In addition, the Medi-Cal expansion will open that program to 36,000 new children, bringing the number of qualified but currently unenrolled youngsters to 678,000.

But as experience with Medi-Cal has shown, eligibility does not equal participation.

Many families are not aware of their eligibility, or they fall in and out of eligibility, or they are daunted by the cumbersome application process, Brown said. Some immigrants fear being deported; others would like to avoid the stigma of welfare. Recent reports of immigrants being pressured to repay welfare benefits they were legally entitled to receive won’t help, Brown said.

Parents whose children qualify for Health Families may, in addition, be scared off by the requirement of paying premiums.

Brown said widespread, aggressive outreach is vital, through community groups, public education forums and schools. “I believe the state is very serious about doing effective outreach and enrollment, but sometimes these bureaucratic barriers arise that need to be knocked down,” he said.

The study states that successful implementation of the program means enrolling nearly all eligible uninsured children, “a level of participation seldom achieved in public programs.”

Lesley Cummings, associate director for health policy at the state Department of Health Services, said: “We too feel that doing an aggressive outreach campaign is crucial. We are in the process of organizing and planning for that.”

The state is spending $21 million to inform eligible families about both programs. In addition, Cummings said, the enrollment forms for Medi-Cal and Healthy Families ultimately will be part of one simplified packet, so families can easily determine which program is appropriate for them. Enrollment can be done by mail.