Simplify, Automate, and Follow the Leader: Lessons on Expanding Health Coverage for Children
Lisa Overton
November 2006
By the time this issue brief was released in 2006, California had learned a great deal about how to provide health insurance for children. The state significantly expanded enrollment in Medi-Cal and Healthy Families, and many counties developed Children’s Health Initiatives (CHIs) to cover children ineligible for state programs. As a result, the number of uninsured children in California fell by nearly one-fifth from 2001 to 2006.
While there is substantial popular support for continuing to expand coverage until all children in California have insurance, many remain uninsured. This issue brief synthesizes key lessons from successful initiatives, as well as from reforms that have been identified but not yet implemented.
The lessons in expanding children's health coverage are grouped into three categories:
- "Simplify" means streamlining the application, enrollment, and renewal processes, as well as simplifying eligibility policies. The issue brief notes that, in 2006, more than 400,000 California children were eligible, but not enrolled in state programs, in part because their families found the application process too difficult to manage. In addition, the publication points out that outreach, assistance, and even the design of materials can increase enrollment.
- "Automate" means using information technology to ensure that enrollment processes are efficient and effective. Computerized forms eliminate many of the common mistakes that are barriers to enrollment. Electronic applications and common databases can securely store each family's application data and supporting documents, making re-certification and other administrative actions easier. Building on technological solutions that help direct children to the appropriate coverage and services can boost the number of children with coverage.
- "Follow the Leader" means building future state efforts on the successes of innovative coverage initiatives at the county and regional levels. These initiatives were particularly effective at forming collaboratives with multiple stakeholders to understand and meet local children's coverage needs in creative and effective ways.
Finally, the issue brief identifies the hurdles yet to be overcome, including perceptions of public coverage programs, access barriers for beneficiaries, and financing issues.
The complete issue brief is available under Document Downloads below.