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Childrens Health Coverage

Wednesday, October 17, 2012

State Outlines Plans for Shifting Kids Out of Healthy Families

On Tuesday, California Health and Human Services Secretary Diana Dooley announced that the state is moving forward with plans to shift about 863,000 children from Healthy Families to Medi-Cal next year, the Sacramento Business Journal reports (Robertson, Sacramento Business Journal, 10/16).

Healthy Families is California's Children's Health Insurance Program and Medi-Cal is California's Medicaid program.

About the Shift

Dooley said that the transition will help streamline and simplify government health care programs for California children.

Eliminating Healthy Families is estimated to reduce state spending by $13 million this fiscal year and $73 million annually after the transition is finished, according the state.

Details of the Timeline

The Department of Health Care Services plans to move all 863,000 children enrolled in Healthy Families into Medi-Cal by Sept. 1, 2013.

The beneficiaries are expected to be moved in four phases, depending on whether their physicians and health plans already accept Medi-Cal (Lin, AP/Vallejo Times-Herald, 10/17).

On Nov. 1, the state plans to send notices alerting the families of the first group of 200,000 children that they will be transitioned to Medi-Cal in January 2013, Dooley said (Sisson, U-T San Diego, 10/16). Additional children will be shifted to Medi-Cal in March, April and August (Sacramento Business Journal, 10/16).

DHCS Director Toby Douglas said that federal officials will need to approve the transition plan before the state can move forward with the shift.

Children's Advocates Express Concern

During a Tuesday legislative hearing, children's health advocates voiced concern about the Healthy Families transition.

Ted Mazer -- communications chair of the San Diego County Medical Society -- said he believes the shift will lead local physicians to reconsider serving low-income children because Medi-Cal reimbursement rates are so low.

"It's not a question of making money, it's a question of how much money do I have to lose before I can't afford to do it anymore," Mazer said.

Other advocates at the hearing called for a delay in the deadlines for shifting children out of Healthy Families.

State Response

Dooley said that the state will work to make sure that the Healthy Families transition does not force children to change doctors.

She said, "We're talking about the neediest kids in California, the ones we should make most certain are not going to experience any lack of continuity in their care" (U-T San Diego, 10/16).



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