Report Offers Blueprint for Modernizing Enrollment in California’s Health Coverage Programs

More than 600,000 are eligible for Medi-Cal and Healthy Families but not enrolled

A new report commissioned by leading California foundations offers a comprehensive roadmap for modernizing systems designed to help children and pregnant women enroll in state-sponsored health coverage programs for which they are eligible.

Produced by Eclipse Solutions, Inc., Modernizing Enrollment in California’s Health Programs for Children: A Blueprint for the Future, is intended to inform policymakers considering coverage expansion options for millions of Californians who are uninsured. The report serves as a guide for the California Department of Health Care Services to implement a 2003 legislative mandate to simplify enrollment into public programs for low-income children and pregnant women.

The release comes amid intense debate in Sacramento over how best to expand coverage to some or all of California’s uninsured. In addition, new Census Bureau figures indicate that in 2006 the number of uninsured nationwide climbed to a record 47 million, including 6.8 million Californians.

As the Golden State’s population has grown in size and diversity, so too have the programs serving low-income children and pregnant women. These programs have become more numerous, more complex, and more isolated from each other, resulting in cumbersome and disconnected enrollment processes that often hinder enrollment of eligible applicants. According to the latest California Health Interview Survey, in 2005 an estimated 636,000 women and children eligible for coverage under the state’s Medi-Cal and Healthy Families programs did not enroll.

“This blueprint offers a ‘user-friendly’ model that eliminates redundancies and inefficiencies of outdated systems that often serve as barriers to enrollment,” said Sam Karp, vice president of programs at the California HealthCare Foundation. “Too often, these obstacles inhibit qualified children and pregnant women from receiving a variety of health care services these programs provide.”

The independent assessment found several overarching problems with these enrollment systems, including the lack of a unified agency-wide approach; use of outdated technology; and processes that are redundant, confusing, and not consumer friendly.

Added Robert Phillips, senior program officer at The California Endowment, “This report will help California begin to do something that the federal government and most other states have been unable to do: realize the benefits of information technology in eliminating barriers to access and in improving health care for children and families.”

The report was commissioned by The California Endowment, the California HealthCare Foundation, and The David and Lucile Packard Foundation.

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About the California Health Care Foundation

The California Health Care Foundation is dedicated to advancing meaningful, measurable improvements in the way the health care delivery system provides care to the people of California, particularly those with low incomes and those whose needs are not well served by the status quo. We work to ensure that people have access to the care they need, when they need it, at a price they can afford.