HEALTHY FAMILIES: State Will Forfeit $590 Million
California stands to lose $590 million in federal money for Healthy Families because the state will not have spent enough money on the program by a Sept. 30 deadline, the Sacramento Bee reports. California joins a number of states that also failed to spend their CHIP funds. Altogether, the states failed to use $1.8 billion in federal funds which will be redistributed to states that have spent their entire allotments. Al Hernandez Santana, outreach coordinator for the California Primary Care Association, said, "This is a shame we are going to have to be sending the money back. We could have done more to ensure adequate health coverage for California families. The bottom line is you can't lay blame at a single source." The state has employed a number of strategies to increase awareness and enrollment in Healthy Families over the past year, but critics argue that California "stumbled" in rolling out the program. Hernandez said, "The state only took baby steps at the beginning. If they had gone full steam and been more aggressive, they could include a whole bunch of new kids." Barriers to enrollment included 28- page program applications, as well as initial outreach efforts that excluded community clinics, which could have referred eligible children. In addition, immigrant families feared that applying for Healthy Families would "jeopardize their ability to become U.S. citizens." Grantland Johnson, state Health and Welfare secretary, said that "since Gray Davis took office in January 1999," many of these barriers have been eliminated. The application is now only four pages long and is written in more languages than the original version; more money has been allocated toward expanded outreach efforts; and an "immigration clarification" has eased worries among immigrant applicants. Moreover, Healthy Families eligibility has been expanded to include children from families earning 200%-250% of the federal poverty level, and the state recently approved "an additional $425 million that will be applied toward the next three-year federal grant" to successfully enroll every eligible child.
Is the Federal Government at Fault?
Some critics argue that federal rules have hindered the state's progress in enrolling kids. One such rule prohibits a family from qualifying for Healthy Families if the children are eligible for Medi-Cal. Johnson said, "There is concrete evidence ... that if given a choice, (applicants) will choose Healthy Families more often than Medi-Cal. They should not be barred from doing it." Some families say they prefer Healthy Families over Medi-Cal because they don't feel as if they are "taking money from the government." Johnson said that California is aligning with other states that are trying to persuade the federal government to extend the deadline for spending federal funds for the program. And the National Governor's Association argued that states "need more flexibility in using the money, particularly in how much they can spend on recruiting children into the program and in creating partnerships with employers to enroll children of private sector employees." California thus far has enrolled 323,000 children, or about half of the state's eligible children, in Healthy Families (Griffith, 8/19).