Health Insurance

The Covering Kids and Families program was a national initiative of the Robert Wood Johnson Foundation to reduce the number of eligible but uninsured children and adults through enrollment in Medicaid and SCHIP. This report presents trends in media use and in-person outreach conducted by state grantees and local projects funded through the initiative. While grantees faced funding and staffing limitations, demand for their services remained high due to decreases in state-funded outreach. Grantees stretched their resources by partnering with other organizations, relying heavily on media outreach to reach large numbers of families, and performing outreach at already-established events.

Health reform is expected to have a number of positive effects on the lives of children age 18 and under. Millions of uninsured kids are likely to gain coverage through either Medicaid or the new health insurance exchanges. Expanded coverage for parents will also increase children's coverage and access to care. New requirements on private plans, increased Medicaid reimbursement for primary care, and investments in public health and prevention will also likely have positive effects on children. Updated 7/28/10

Overall, the Los Angeles Healthy Kids program has greatly improved coverage and access to dental care services for children enrolled in the program. However, as with many public insurance programs, the Los Angeles Healthy Kids program has been confronted with numerous challenges in meeting the dental care needs of program enrollees, such as initially assigning different dentists to some enrollees than they had selected, confusion over charges for dental services and underreporting of encounter data.

Time-limited ARRA subsidies to laid-off workers for COBRA continuation coverage have substantially raised enrollment, even though layoffs sharply cut household income. The two largest data sets reviewed here showed average rises in take-up rates of 43 percent and 100 percent. However, rates varied widely across employers, and tax-subsidy claims to the IRS are thus far running much lower than expected. Coming closer to universal coverage for this population or for all Americans would require higher subsidy and possibly also a mandate to obtain coverage-two features that increase COBRA participation in a separate Massachusetts program for unemployed residents.

For 25 years, low-income, non-citizen Los Angeles County residents ineligible for Medi-Cal coverage have had access to emergency, pregnancy-related, and nursing home services through the Emergency Medi-Cal (EMC) program. With the 2003 creation of Healthy Kids, many children enrolled in EMC became eligible for more comprehensive coverage under Healthy Kids. But no formal mechanism was established to coordinate the programs, and the potential for children to be enrolled in both Healthy Kids and EMC was created. This study examines the benefits and challenges created by dual coverage and efforts made to capture state and federal funds to support Healthy Kids.