Connecting Kids to Health Coverage: Evaluating the Child Health and Disability Prevention Gateway Program

Catherine Teare, Associate Director, High-Value Care
Len Finocchio, Blue Sky Consulting Group
Victoria Martin-Young


This is archived content; for historical reference only.

The automated process known as the Child Health and Disability Prevention (CHDP) Gateway debuted in 2003 as California’s largest effort to enroll children in health insurance programs. It was an unprecedented experiment that used innovative methods to identify and pre-enroll eligible children into temporary Medi-Cal coverage, and then facilitate their transition into long-term enrollment in Medi-Cal or Healthy Families.

Three years later, CHCF commissioned research to examine the program’s performance, identify successes and challenges, and create a road map for the future.

The report found that while the CHDP Gateway was successful in its goal of pre-enrolling large numbers of children into temporary Medi-Cal coverage, it had less success moving those children into long-term coverage.

Among the key findings:

  • Approximately 600,000 children were pre-enrolled in temporary Medi-Cal through the CHDP Gateway in one year.
  • In more than 90% of pre-enrollments, families requested a joint application for Medi-Cal and Healthy Families, but fewer than 20% returned them in time to have their children’s temporary eligibility extended.
  • Denial rates for long-term coverage were high, mostly because of a “failure to cooperate” with follow-up requests for information.
  • Approximately 75,000 Gateway children (11% of pre-enrollees) gained regular, long-term Medi-Cal or Healthy Families coverage.

The analysis confirmed that the CHDP Gateway is a powerful tool that should be refined and strengthened. It pointed to the value of short-term improvements, including technology and policy fixes aimed at better follow-up, training, and coordination. On a broader scale, the authors’ findings suggest that the state should analyze the role of the gateway in expanding health coverage for children, and aim to maximize its effectiveness as part of a comprehensive strategy to streamline and integrate enrollment in public programs.

The complete report is available under Document Downloads.