California made significant strides in reducing the number of uninsured children from an estimated 778,000 in 2003 to 683,000 in 2007, a 12% decline. But the pace of these gains, driven in part by expansions in Medi-Cal and Healthy Families, has tapered off in recent years. Enrollment in public programs has slowed amid funding cutbacks and strained budgets, even though four out of every five children who remain uninsured in the state are now eligible for such coverage.

This almanac presentation provides an overview of trends in children's coverage and insurance programs in California. Among the key findings:

• Medi-Cal and Healthy Families are key sources of coverage for children in low-income households that together have closed the coverage gap among families with incomes up to 250% of the federal poverty level.
• Healthy Kids programs are also important for children's coverage. Twenty-four counties operate Healthy Kids programs and four others rely on California Kids.
• Children are less likely to have employment-based coverage than adults and are more likely to be enrolled in public programs in California.

The future of children's health insurance coverage in California is unclear. While the state's economic downturn and budget crisis will likely make it difficult to increase the number of insured children, Congress and the president reauthorized the Children's Health Insurance Program (CHIP), which provides new policy options for expanding coverage. It is also likely that national health care reform, if enacted, would benefit children in California.

The complete presentation is available under Document Downloads.