Half of noncitizen CalKids children are not re-enrolled

A study by the California HealthCare Foundation has found that about half of the enrollees in L.A.CalKids, a health insurance program for low-income, noncitizen children, do not re-enroll before their coverage lapses, despite the fact that members don’t have to pay premiums.

Analysts found the program was "highly successful" in recruitment efforts, enrolling 6,000 children within two years, 2,000 more than the target enrollment.

Although enrollees reported high satisfaction with the program, about half did not re-enroll, the study found.

Researchers found that 30% of enrollees had changed telephone numbers after enrollment, and concluded that family stability was an important factor in re-enrollment. They said that more frequent contact with enrollees could improve re-enrollment.

Meanwhile, a Kaiser Commission on Medicaid and the Uninsured study of State Children’s Health Insurance Program outreach efforts in Los Angeles County, CA, yielded several lessons:

1. Coordinated outreach and enrollment efforts can increase coverage in publicly-funded programs among low-income children. Although low-income parents of uninsured children said in focus groups and surveys that they would not consider enrolling their children in MediCal because of the "welfare stigma" and "administrative hassles," more than 110,000 children have been enrolled in Los Angeles County and more research is needed on the parents of newly-enrolled beneficiaries to better understand why they chose to enroll their children.

2. Although progress has been made, the program’s administrative complexity still inhibits greater participation. There are bills pending in the California legislature to address some of the issues that county officials say are creating barriers to enrollment.

3. Accurate data can provide important baseline information about target populations. Profiles that were developed provided valuable information to county officials on health insurance coverage, access to health care services, and health status of the population.

4. County agencies can provide a strong foundation to launch and sustain outreach and enrollment efforts, but they must build trusting relationships with community-based organizations to achieve success.

5. An evaluation of county actions is important to determine which are effective and which are not.

6. Because of high turnover rates among outreach and enrollment staff, training efforts need to be ongoing.

[Contact the California HealthCare Foundation at (510) 238-1040 and the Kaiser Commission on Medicaid and the Uninsured at (202) 347-5270.]