The “Fix” is in. . . .

Health Access attended the Managed Risk Medical Insurance Board (MRMIB) board meeting on Thursday in particular because we were interested in the status of how California’s children were faring under the Healthy Families Program now that the eligibility restrictions have been removed. On July 17 the state reluctantly established a waiting list of eligible children for the state children’s health insurance program due to funding shortfalls. After short-term rescue strategies were cobbled together this fall to provide additional money to fund the program, everyone at the meeting was anxious for news about how quickly eligible children’s applications were being processed. Here’s what we learned at the public board meeting:

  • Although the state discontinued the waiting list on September 16, families were still receiving incorrect notices for another week that they were being put on a waiting list.
  • As of September 30 Healthy Families enrollment had fallen from over 920,000 to 871,335.
  • Advocates were very disappointed to learn how slowly the administrative vendor was working down the waiting list. They have processed only about one-quarter of the wait-listed children’s applications. They anticipate that they will process the remaining applications by mid-November, but hope to have the bulk of them reviewed by the end of this month.
  • MRMIB is projecting much higher retention rates of new applicants because of the worsening economy, and the slowness of the job recovery picture (because employer-based health insurance for families is often offered to new employees.)

Although everyone voiced this concern at the outset, we should remember how long it takes to fix the administrative actions that were undertaken to limit enrollment in public programs. We should not undertake these restrictions lightly. Healthy Families is experiencing resurgent enrollment for this program and the families who are enrolled are expected to remain eligible for a longer period of time due to the economy. In addition to the new influx of applications, Healthy Families must institute an expedited processing of wait-listed children that built up during the time when enrollment was limited due to uncertain financing. In addition, they have to correct the confusion that has resulted from the off-again/on-again status of enrollment in the program which may have deterred some eligible families from even applying.

Even though we have endured these restrictions on enrollment, longer-term financing for children’s health insurance is far from assured–and the rules may be changing under several scenarios for health care reform. It is important to remember that we should place restrictions on enrollments for public programs only in the most extreme financial circumstances because the process of undoing the limits put in place takes way longer than anyone wants it to!

Health Access California promotes quality, affordable health care for all Californians.
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