Enrollment in Healthy Families Slows
Enrollment in Healthy Families slowed "dramatically" last fiscal year, in part because of a 15% staff reduction at the Managed Risk Medical Insurance Board and cuts over the past three years in outreach assistance programs, the Sacramento Bee reports. MRMIB administers Healthy Families.
About 8,000 new beneficiaries have enrolled in it since January, when the program had an estimated 685,000 beneficiaries. Legislators estimated that the program would have 774,077 beneficiaries by July 1, 2005. Some advocates say that about 300,000 additional children are eligible for coverage under the program.
The reduction in MRMIB staff has generated backlogs of up to four months for families appealing denials of coverage, according to the Bee. In addition, health care advocates have said that administrative problems, such as lost or misplaced applications, have contributed to the decline.
The board in January also converted to a different contractor to administer the program, creating additional delays in the application process, according to Janette Lopez, MRMIB deputy director for eligibility.
Lopez said that the number of certified application assistants in underserved areas has been reduced, and subsequently, several incomplete applications have been received. She said that the process is completed entirely by mail.
It costs about $77 to process a Healthy Families application through a private contractor and $338 to process it through a county welfare office, according to the Bee.
The California Performance Review, a review of state government commissioned by Gov. Arnold Schwarzenegger (R), recommended consolidating MRMIB with the Department of Health Services to reduce costs, but some say such a move would further slow the application process.
Healthy Families officials say the enrollment decline is related to a decrease in the number of beneficiaries who are retained following annual reviews.
Jeff Okey -- a spokesperson for the California Endowment, which administers an outreach program to enroll beneficiaries -- said that "language barriers and complicated procedures" have caused many beneficiaries to "fall out of the system."
A group of health care providers, union members and business leaders, on Tuesday is scheduled to announce a proposal to reform the program and expand health coverage to uninsured children, according to Deena Lahn of the Children's Defense Fund. The coalition also will release data from the University of California-Los Angeles' Center for Health Policy Research on the number of uninsured children in the state.
Lahn estimated that the proposal would cost $200 million to $300 million annually and would provide affordable health coverage for all children in California by 2007. She said, "We're either paying through Healthy Families, Medi-Cal, county programs and more expensive emergency room care. Most of the money is already in the system" (Rojas, Sacramento Bee, 12/13).