Major Transition with Minor Disruption: Moving Undocumented Children from Healthy Kids to Full-Scope Medi-Cal

Eugene Lewit, Stanford University


Implementing Medi-Cal coverage expansion for hundreds of thousands of undocumented immigrant children will be complicated. In addition to the many children with no prior coverage, many others currently have some form of coverage that is administered separately from Medi-Cal, such as Healthy Kids, other county programs, or the Kaiser Permanente Child Health Program. And some are enrolled in more than one program. Children with existing coverage are at risk of having their coverage, care, or both disrupted during their shift to full-scope Medi-Cal.

Major Transition with Minor Disruption: Moving Undocumented Children from Healthy Kids to Full-Scope Medi-Cal explores how informed collaborative implementation of the new coverage option can help maximize the benefits children and families realize from the new coverage option and mitigate the risk of disruption in coverage and care for those already enrolled in comprehensive coverage.

Key points raised in the paper include:

  • The transition plan should be developed through an inclusive process that recognizes the different programs children are enrolled in, the different participants in the implementation work, and the value of information sharing and communication among all stakeholders.
  • Children’s Health Initiatives (CHIs) and their local partners will play a big role in shepherding Healthy Kids enrollees through the transition process and maintaining coverage in Healthy Kids programs until the transition is complete. Local social service offices and health plans should coordinate with CHIs and their local partners on this front.
  • DHCS and state policymakers should consider allowing consenting Healthy Kids enrollees to transition directly into the same managed care plan in Medi-Cal, or granting Medi-Cal eligibility to children based on their enrollment in Healthy Kids, to smooth the transition and reduce the burden on families, the CHIs, and local social service offices.
  • The state’s 2009 plan to transition children from Healthy Kids programs to Medi-Cal and Healthy Families, along with the LIHP transfer, could be used to inform the full-scope Medi-Cal transition effort.

While the paper focuses primarily on transitioning children from the 10 county-based Healthy Kids programs to full-scope Medi-Cal managed care, it also provides information on other coverage programs for these newly eligible children, as many of the issues discussed are applicable to children transitioning from other programs as well.

The full issue brief is available under Document Downloads.