Half of Eligible Children are Enrolled in Healthy Families
Only half of the state's eligible children are enrolled in Healthy Families, and health advocates say the program's "cumbersome enrollment process" is to blame, according to the Los Angeles Times. A UCLA Center for Health Policy Research study, to be released next week, found that of the estimated 741,000 children eligible for Healthy Families, only 375,000 had enrolled by last month. To boost enrollment, Gov. Gray Davis (D) is requesting $42.1 million in his new budget proposal for outreach efforts, but advocates say the real problem lies in the program's application, which is "unnecessarily difficult to navigate." Despite efforts to simplify the process, the state has been forced to train "hundreds of workers to walk people through" the procedure.
Eligibility for Healthy Families and Medi-Cal is based on age and income. Therefore, members of the same family may be placed in different programs -- some in Medi-Cal and some in Healthy Families. To receive coverage, families must apply in writing, provide proof of income and allow 10 days for the state to respond. If the state determines a family should be in Medi-Cal instead of Healthy Families, the application is forwarded to the county, where it may take several weeks to process the request. In addition to the administrative difficulties, the Times reports that enrollment efforts are hindered by language and cultural barriers. With a large immigrant population, many potential beneficiaries come from countries where private physicians "are used as a last resort" and it is customary to utilize public clinics or pharmacies. In addition, many incorrectly believe they will be deported if they apply for assistance. Richard Brown, director of the UCLA Center for Health Policy, said the "structure and focus" of the process is intended to keep ineligible people from receiving benefits. He added, "We could make this far simpler. We have to dump the philosophy ... that we keep out all the ineligible people. And we have to adopt a new attitude, which is to get every eligible child."
Currently, the state is working to streamline the enrollment processes for both Healthy Families and Medi-Cal. For example, the state, along with the California HealthCare Foundation, is piloting an online application process, called Health-e-App. In addition, the burden of enrolling applicants in the appropriate program would begin to shift from the county to the state under a plan to offer benefits to parents of enrolled children. Under the expansion, which is awaiting federal approval, California Secretary of Health and Human Resources Grantland Johnson said that families would complete universal applications for coverage and state administrators would "sort out" individual family member eligibility. Despite enrollment difficulties, Johnson said that Healthy Families has made "great strides" during the Davis administration. When Davis took office in 1999, 32,000 of 600,000 eligible children were enrolled in the program. By the end of last month, new children were enrolling in Healthy Families at a rate of 20,000 per month, according to Johnson. He added, "Anybody who thinks that in a state like California you can do this overnight is simply failing to appreciate the challenge. You can't just wave you hand with a magic wand" (Bernstein, Los Angeles Times, 2/8).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.