MEDI-CAL & HEALTHY FAMILIES: Overcoming Stigmas to Reach Uninsured Children
Officials estimate that, largely "because of fear, shame and misunderstanding about signing up for state aid," 1.7 million children statewide still lack health insurance. The Fresno Bee echoes recent public consensus that welfare reform is largely to blame. Children of families that lost Medi-Cal eligibility under welfare reform were expected to be covered under Healthy Families -- the state's CHIP program -- but few have actually been enrolled. And the children of families whose incomes are too low for Healthy Families are still, in fact, eligible for Medi-Cal. The "hitch" is that state health workers must now find and re-enroll them in the program. The difficulty rests in overcoming high outreach costs, lack of information and negative public perceptions. Jeanne Welton, an outreach program manager for Madera County, estimates 90% of families recently enrolled were not aware of their eligibility. Also, the stigma of receiving public support prevents many from joining; Welton noted that officials must assure parents that it is "just as OK to access public health care coverage as it is to send our children to public schools."
Outreach in Fresno
The Fresno County outreach program -- only one of four in the state operated by a not-for-profit agency -- received a state grant for over $700,000 to increase the number of Medi-Cal beneficiaries. Workers are trying to encourage reluctant immigrants to apply for health coverage, and to correct the misconception that because they do not speak English, they do not qualify. Other immigrants are intimidated by the exhaustive 20-page forms and the issue of "public charge" -- a term used for deportation purposes, describing noncitizens largely dependent upon the government for subsistence. But new federal regulations specifically protect immigrants' access to public assistance. Health workers involved in outreach programs have many suggestions on how to make Medi-Cal less "intimidating," the most popular of which is to make payments on an annual rather than a quarterly basis. This system would especially benefit farmworkers and their families, whose incomes fluctuate with the seasons. Officials realize they are facing a "rocky road," but contend that the results of allowing the number of uninsured children to grow are far worse (Anderson, Fresno Bee, 11/15).