About Half of Enrollees in Los Angeles Children’s Health Insurance Program Do Not Re-Enroll, CHCF Study Finds

About half of the enrollees in L.A. CalKids, a health insurance program for low-income non-citizen children, do not re-enroll in the program before their coverage lapses, despite the fact that the program does not require members to pay premiums, according to a study sponsored by the California HealthCare Foundation. The study, conducted by the University of Southern California Center for Health Financing, Policy and Management for CHCF, examined the program's "effectiveness in outreach," impact on the "utilization and cost" of health services and "enrollee satisfaction." Researchers conducted phone interviews with enrollees at the time of enrollment and a second time after a period of six months to a year. The study found that L.A. CalKids, which covers uninsured non-citizen children in families that earn less than 250% of the federal poverty level, "was highly successful" in enrollment efforts. About 6,000 children -- 2,000 more than the program's target enrollment -- enrolled within two years of the launch of L.A. CalKids. The study also found that 90% of enrollees had never had health insurance in the past. In addition, the study found that only 7% of L.A. CalKids enrollees did not receive required health services, compared to 30% in the six months before they enrolled in the program (CHCF release, 3/11). The study also found that dental use among enrollees "surged." The number of enrollees who received dental care doubled to 44% in the first six months of enrollment. Meanwhile, the use of emergency room services dropped, "reflecting a more appropriate use of resources" ("Evaluation of the Los Angeles CalKids Program: Executive Summary," 3/11).

Although enrollees reported high satisfaction with the program, about half did not re-enroll, the study found. Researchers found that 30% of enrollees had changed phone numbers after enrollment and concluded that "family stability was an important factor" in re-enrollment. Researchers said that more frequent contact with enrollees may improve re-enrollment. Dr. Mark Smith, president and CEO of CHCF, said, "CalKids succeeded in demonstrating that formal health insurance could appeal to L.A.'s low-income immigrant families. But maintaining enrollment has been a challenge, just as it has been in Medi-Cal and Healthy Families" (CHCF release, 3/11). The study, "Evaluation of the Los Angeles CalKids Program," is available online. Note: You will need Adobe Acrobat Reader to view the study.