The expansion of Medi-Cal to undocumented children through SB75 Health4All Kids has been implemented through perhaps the most rapid and issue-free transition in California’s healthcare history. Thanks to coordination and communication of state departments, community organizations, foundations, insurers, and advocates, the vast majority of the newly eligible children already enrolled in some type of coverage are either already transitioned to full-scope Medi-Cal or they are well on their way.
Below is a breakdown per group of the newly eligible children sorted by their previous health coverage. There may be 50 to 100 thousand more children who have never been enrolled in health coverage who are newly eligible for Medi-Cal under SB 75, so the work must continue if we are to realize universal coverage for all of California’s children. Even the ones who are enrolled will need help navigating and retaining their coverage.
Restricted Medi-Cal Enrollees (September 2016)
Original Number Pre-Transition: 120,102 (Source: DHCS)
Number Transitioned Currently: 113,559 (Source: CWDA)
Kaiser Child Health Program (September 2016)
Original Number Pre-Transition: 64,395 (Source: Kaiser Permanente)
Number Transitioned Currently: Unknown**
Number of Healthy Kids Remaining (9/28/2016)
Healthy Kids Sonoma County: 13 kids (will terminate its program 11/30/16)
San Mateo Healthy Kids: 683 kids *
San Francisco Healthy Kids: 923 kids*
Santa Clara Healthy Kids: Approx. 2000 kids*
Inland Empire Healthy Kids: 868 kids
Los Angeles Healthy Kids: Unknown
All other programs have 0 kids remaining.
(All information above was gathered directly from the organizations named.)
*San Mateo, San Francisco and Santa Clara’s Healthy Kids programs will remain open through CCHIP funding and other local funding sources.
We have not gotten the total back yet from Los Angeles. The number from Santa Clara is approximate, and includes both kids who will transition to Medi-Cal and kids who will remain in the CCHIP-funded program.
The Transition Timeline and Information Delay
We want to point out that while this transition from Healthy Kids has gone remarkably quickly and well, there is still approximately a 6-month delay between when the transition process begins and when we have confirmed information that the child is enrolled in Full Scope Medi-Cal. A brief explanation of the timeline and efforts is below:
Final Transition Notices from DHCS to newly eligible Restricted Medi-Cal enrollees go out.
County Eligibility Divisions begin the transition to full scope aid codes
Some Healthy Kids programs begin notifying their enrollees of the transition
June – Present
Appointment Scheduling by Healthy Kids Programs for enrollment to Full Scope Medi-Cal begins.
One to three appointments per household to complete an application
30-45 days to process a complete application
Up to 90 days for application approval, allowable by law, but in many cases still takes longer
Following application approval, up to 60 days for plan selection to Medi-Cal Managed Care
Successfully enrolled children are removed from the Healthy Kids program.
Information delay on successful enrollments
If it weren’t for how quickly the transition has gone, we would not be able to provide any real numbers yet as of this point. The Healthy Kids Programs were proactive in enrolling kids in to Restricted Medi-Cal before the transition so they could be immediately transitioned into full-scope, and it was this preparation and coordination with the state that has made the transition a success.
We hope this explains well what how the transition is going. Again, unfortunately, we will not have numbers from Kaiser until at least November because of the time it takes for their own information systems and processes.
The CCHI Team