Report Raises Access to Care, Enrollment Issues Under Reform
California policymakers must address several issues so the state has the capabilities to handle an expected influx of millions of newly insured individuals under the federal health reform law, according to a new study by the California Endowment and the Urban Institute, Payers & Providers reports.
More than six million California adults and children could become eligible for health insurance coverage under the reform law (Payers & Providers, 8/4).
According to the report, the reform law will:
- Allow low-income, uninsured parents to obtain coverage;
- Increase the likelihood that children who are eligible for public insurance will enroll because of expanded outreach initiatives; and
- Offer insurance subsidies for uninsured children (California Endowment release, 8/3).
Barriers to Expansion of Coverage
According to the report, county social service agencies rely on "labor intensive" and "paper-based" systems to enroll individuals in Healthy Families and Medi-Cal. Healthy Families is California's Children's Health Insurance Program, and Medi-Cal is the state's Medicaid program.
The report said these systems could be overwhelmed when faced with new demand.
In addition, the report noted that other factors could limit the expected expansion of insurance. For example:
- Current eligibility requirements could burden applicants; and
- Limited payments to Medi-Cal providers could reduce access to care (Payers & Providers, 8/4).
What Can Be Done
Stan Dorn -- a senior fellow at the Urban Institute and author of the report -- noted that the ability of Californians to obtain coverageÂ depends on how state policymakers can:
- Streamline enrollment in public plans;
- Address issues related to health care provider participation in Medi-Cal; andÂ
- Work on making coverage more affordable to low-income families (California Endowment release, 8/3).
In addition, the report said that current enrollment systems could be replaced with computerized or online systems that are being developed to help set up state-based health insurance exchanges.
The report also noted that reform law funding is available to improve the Medicaid enrollment process (Payers & Providers, 8/4).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.