Healthy Families

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Last Phase of Transition: Rural Californians Move to Medi-Cal Managed Care

(Ben Ramirez: Flickr)

(Ben Ramirez/Flickr)

By David Gorn, California Healthline

Rural Californians already have challenges accessing health care and changes to Medi-Cal, the state’s Medicaid program, could further complicate matters.

Rural areas have fewer physicians and facilities and services are spread out over greater distances than they are in urban and suburban areas. Rural areas also have a disproportionately high number of lower-income, Medi-Cal-eligible residents which creates a challenging situation for state health officials charged with providing medical coverage in rural settings.

“The rollout has gone relatively smoothly, but the access to providers — that’s a real question still.”

On Nov. 1, the state launched an ambitious plan to transition Medi-Cal beneficiaries in rural areas from fee-for-service care arrangements to managed care plans. The move shifts 28 rural counties to the financial model the state is using throughout the rest of the state.

Also on Nov. 1, the state launched the last phase of its Healthy Families transition — moving children in rural counties to Medi-Cal managed care. Healthy Families is California’s Children’s Health Insurance Program. Continue reading

Low-income Parents Brace for End of ‘Healthy Families’

By Mina Kim

Maria Garibay worries her daughters won't be able to stay with their current doctors when they switch from Healthy Families to Medi-Cal next year.(Mina Kim: KQED)

Maria Garibay worries her daughters won't be able to stay with their current doctors when they switch from Healthy Families to Medi-Cal next year.(Mina Kim: KQED)

Next January, the state will begin transferring hundreds of thousands of low-income kids from its popular Healthy Families insurance plan to Medi-Cal — which offers medical coverage to the state’s poorest residents.

Ending Healthy Families was one of Governor Jerry Brown’s budget-balancing priorities and now families are feeling the weight of that decision.

At Children’s Health Initiative in Napa, a nonprofit that helps get kids into affordable health plans, Maria Garibay has just gotten the news. Next year, her three girls will be moved from Healthy Families to Medi-Cal.

Speaking through an interpreter, Garibay says she’s worried her monthly premium will go up. That’s because last year Medi-Cal told her she’d need to start paying $1300 each month, per child, because of her income from a part-time restaurant job.

But then Garibay learned that she qualified for Healthy Families. The federally subsidized program is for families whose incomes are just above the federal poverty level. Under Healthy Families, Garibay pays a total premium of $14 a month. It’s a godsend for Garibay whose oldest daughter has a heart condition. Continue reading

Children’s Advocates Divided on Healthy Families Transition

By Emily Bazar, CHCF Center for Health Reporting

(David Mason: Flickr)

(David Mason: Flickr)

As the Legislature debated — and ultimately approved –- a budget-cutting plan to transfer nearly 900,000 California children on the Healthy Families program into Medi-Cal next year, dozens of groups joined in opposition.

They ranged from the California Medical Association, a professional organization that represents the state’s doctors, to the California Primary Care Association, which represents community clinics.

Mostly, they were groups that focus on children and families, such as Children Now and United Ways of California.

They warned that the transition could disrupt care for thousands of children and ultimately lead to a lack of access to care, particularly in parts of California where doctors – especially those who accept Medi-Cal – are scarce.

But it turns out that opposition to the proposal was not unanimous, even among nonprofits that advocate for children and families. Continue reading

California Budget Proposal Would Move 880,000 Children Off Healthy Families

A kindergartner visits the dentist, one of the services parents and advocates are worried about accessing when they switch to Medi-Cal. (heraldpost/Flickr)

Jacqueline Dandeneau understands why children’s health advocates are so upset.

The Humboldt County resident, and mother of a 12-year-old and a 6-year-old, was a longtime subscriber to Healthy Families. That’s California’s medical insurance program for kids whose parents make just too much to qualify for Medi-Cal, but struggle to afford private health insurance payments.

“We were a ‘Healthy Families’ family and very happy to be so. The paperwork was easy and we had great dental access,” said Dandeneau.

Then, came the economic downturn, their fortunes changed for the worse and their coverage changed to Medi-Cal.

Dandeneau says in their county there are few providers and they are waiting up to a year for appointments.

“We have to drive 3 hours to go to Redding,” said Dandeneau, pointing out it’s a challenging system for working parents struggling to juggle commitments. “So I see right now the system is taxed as it is. We as a Medi-Cal family can’t get enough coverage as it is. Let alone if we have all the Healthy Families kids fall into that service.”

Wendy Lazarus with Children’s Partnership says the idea that all of the 880,000 children in Healthy Families would immediately be moved in Medi-Cal as part of the budget solution was a big surprise. Continue reading

Governor’s Budget: Health and Social Services Cuts

(Jupiterimages: Getty Images)

(Jupiterimages: Getty Images)

California’s Governor Jerry Brown released his budget for the 2012-13 fiscal year today and it includes “painful” cuts in healthcare and social services.

Reaction has been swift from groups that work on behalf of the poor and disabled.

From the HHS Network of CA, a coalition of organizations including the Western Poverty Law Center and Health Access:

We are appalled that Governor Brown’s solution to California’s budget crisis is $2.5 billion cuts to essential health and human services. Since 2008, California’s health and human services have suffered an astounding $15 billion in cuts, and this budget only continues the gutting of the social safety net that so many Californian families depend on. From our quick analysis, the Governor is making a $946 million cut to CalWORKS, an $842 million cut to MediCal, a $163 million cut to In-Home Supportive Services, a $447 million cut to child care, and $87 million in cuts to various other HHS services.

From Darcel Lee, Executive Director of the California Black Health Network:

Once again, the proposed budget balances the deficit on the backs of our most vulnerable communities,” said B. Darcel Lee,  (CBHN). “The number of uninsured in California grew to 7 million last year. At a time when so many families are struggling to make ends meet, we can’t afford to take away basic support programs for working families.

From the California Medical Association, reacting to the planned transition of children and teenagers in the Healthy Families Program to Medi-Cal:

“On one hand, Governor Brown is advocating for a 10 percent cut in Medi-Cal. On the other hand, he wants to add just under a million more young people to the program, which data shows is already struggling to meet the needs of the existing patients,” said Dustin Corcoran, CMA CEO. “The Medi-Cal provider network will simply not be able to accommodate this large influx of kids and teens. It’s unclear how anybody wins in that scenario.”

The governor is also calling for new taxes to close the budget deficit.  From Jean Ross, Executive Director of the California Budget Project:

The Proposed Budget includes major reductions in a number of critical areas, especially support for low- and middle-income Californians who need health coverage, child care, help in moving from welfare to work, or help financing a college education. Still, the governor should be commended for a balanced approach that calls for new revenue, instead of taking a cuts-only approach to addressing the state’s fiscal challenges.