How Can California Policymakers Help Low Income Children Benefit from National Health Reform?

A New Study Provides Governor Brown, Health Care Providers and Congress Direction to Help Maximize Benefit for Successful Implementation

SACRAMENTO, Calif.--(BUSINESS WIRE)-- A recent report, commissioned by The California Endowment, outlines the expected gains for California’s low-income children as a result of the new federal health care law, the Patient Protection and Affordable Care Act (ACA), as well as the critical factors policymakers must address to ensure gains for lower-income children in California and across the nation.

"The implementation of the ACA should increase health coverage for California's low-income children and families," said Stan Dorn, Senior Fellow at The Urban Institute, who authored this report. "However, the extent of these families' gains will depend on how effectively state policymakers streamline enrollment in public coverage programs, address Medi-Cal's provider participation problems, and consider strategies to make coverage more affordable for low-income parents."

The report also finds outdated and cumbersome eligibility requirements can burden applicants and prevent eligible families from enrolling in Medi-Cal and Healthy Families, the existing public health care programs for low-income Californians. Additionally, limited Medi-Cal provider reimbursements could reduce access to care for existing and newly eligible participants.

Reducing providers’ administrative burdens and improving access to Medi-Cal and Healthy Families may be possible through targeted rate increases, increasing the use of telemedicine, and strengthening the capacity and broadening the scope of practice for safety-net providers.

“Medi-Cal’s systems for enrollment and reimbursement are too onerous for health care consumers and providers, respectively,” said The California Endowment’s President & CEO Robert K. Ross, M.D. “We must streamline these processes in order to gain efficiency so that we can effectively implement the federal health law and provide Californians with access to the health care they deserve.”

Specifically, the report found that the ACA will improve health care for California’s low-income children in three ways:

  • Previously uninsured, low-income parents will gain coverage and access to care, thus improving their children’s likelihood of coverage and access to care;
  • Children who currently qualify will be more likely to enroll in Medi-Cal and Healthy Families due to expanded outreach programs; and
  • Uninsured children who are currently ineligible for assistance will receive coverage due to new subsidies.

However, the extent of the possible gains could be limited by several factors, including:

  • The system California uses to determine Medi-Cal eligibility;
  • The provider network that serves low-income communities;
  • The accessibility and affordability of subsidized coverage in the exchange; and
  • The possible end of certain federal allotments after 2015.

“The health of our children must be a priority for California’s policymakers,” said Deena Lahn, Policy Director of the Children’s Defense Fund. “Children need comprehensive, preventive care, such as the ability to get eyeglasses when they can’t see the board at school, and asthma medications that will keep them out of emergency rooms. This study will assist California in making use of the landmark federal health care legislation, which will impact the ability of California’s children to grow up healthy and strong.”

Currently in California, three million lower-income children participate in Medi-Cal and 825,000 children participate in Healthy Families. While the state-run programs cover over 80 percent of eligible children, more than two-thirds of the children eligible for these programs are not enrolled.

To view the study, click here.

The California Endowment

The California Endowment, a private, statewide health foundation, was established in 1996 to expand access to affordable, quality health care for underserved individuals and communities, and to promote fundamental improvements in the health status of all Californians. Headquartered in downtown Los Angeles, The Endowment has regional offices in San Francisco, Sacramento, Fresno and San Diego, with program staff working throughout the state. From 2010-2020, The Endowment will focus the majority of its resources on its 10-year strategic plan Building Healthy Communities. For more information, visit The Endowment’s Web site at

The Urban Institute

The Urban Institute gathers data, conducts research, evaluates programs, offers technical assistance overseas, and educates Americans on social and economic issues — to foster sound public policy and effective government. It analyzes policies, evaluates programs, and informs community development to improve social, civic, and economic well-being. Working in all 50 states and abroad in over 28 countries, The Urban Institutes shares research findings with policymakers, program administrators, business, academics, and the public online and through reports and scholarly books.


The California Endowment
Jeff Okey, 213-928-8622

KEYWORDS:   United States  North America  California

INDUSTRY KEYWORDS:   Health  Public Policy/Government  Healthcare Reform  Public Policy  State/Local  White House/Federal Government  Baby/Maternity  Children  Consumer  Family  General Health  Managed Care