Refugees, Asylum Seekers

Children enrolling for a medical reason in Healthy Kids reported a range of common conditions including allergies, anemia, asthma, cough/cold, stomach problems, and ear/eye infection as their reason for enrollment. A large portion (67%) of parents report enrolling because the child needed prescription medication the family could not afford. Enrollment was associated with improved access to health care and lower out-of-pocket costs. However, families of children enrolled for a medical reason faced persistent barriers in accessing sub-specialty care and demonstrated higher use of emergency department services compared to those not enrolled for a medical reason. Los Angeles, CA: University of California – Los Angeles. May 2009.

The Los Angeles Healthy Kids program, during its first four years, extended comprehensive, affordable coverage to over 40,000 poor and vulnerable children, and improved their access to and use of care. Yet, the program also faced serious challenges, primarily related to financing. Funding for children ages 6 through 18 ran short in spring 2005 and Healthy Kids capped their enrollment. State health reform efforts that could have stabilized funding for the program have failed. Based on interviews with over 40 stakeholders, this case study analyzes the complex challenges that the Los Angeles Healthy Kids program faces at this critical juncture. Washington, DC: The Urban Institute. November 2009.

In December 2006, U.S. Immigration and Customs Enforcement agents simultaneously raided Swift & Company meatpacking plants in Colorado, Iowa, Minnesota, Nebraska, Texas, and Utah, detaining nearly 1,300 undocumented immigrants in the largest immigration enforcement action in recent history. The consequences of these raids also spread to many U.S.-born children, who faced the loss of a parent and great instability. The unique circumstances of these citizen children pose fundamental questions for our immigration law system about their rights and interests—questions that remain unresolved more than two years after the arrests.

This brief presents highlights from rigorous, independent evaluations of the Healthy Kids programs in three California counties: Los Angeles, San Mateo, and Santa Clara. Launched by Children’s Health Initiatives (CHIs) in these counties between 2001 and 2003, the three Healthy Kids programs provide children with comprehensive health insurance coverage, including a broad range of medical, dental, and vision care; prescription drugs; and mental health services. Children are eligible for Healthy Kids if they are ineligible for California’s two major state insurance programs, Medi-Cal and Healthy Families, and live in families with incomes up to 300 percent of the federal poverty level (FPL) in Los Angeles and Santa Clara counties, and 400 percent of the FPL in San Mateo County. Most of the children enrolled in Healthy Kids have family incomes at or below the poverty level. This brief describes some of the many positive impacts that Healthy Kids programs have had on children’s access and use of dental services. For more information on these and other findings on the three programs, see http://www.urban.org and http://www.mathematica-mpr.com/health/chi.asp.

A second series of focus groups with parents of children enrolled in the Los Angeles Healthy Kids program found that opinions of the program remain favorable despite its recent fiscal challenges. Healthy Kids had provided comprehensive, affordable coverage to nearly 45,000 poor children from birth through age 18 until mid-2005, but funding shortfalls led the program to cap enrollment for older children and enrollment levels for all children subsequently slipped. Still, the program remains highly valued by parents for providing high quality, comprehensive coverage and parents report good access to linguistically appropriate care and affordable out-of-pocket costs.