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Coverage for All Children Approaches: Health4All Kids Webinar Breaks It Down

The Children’s Partnership joined with partner organizations (see Figure 1 below) to host a “Health4All Kids” webinar on the upcoming Medi-Cal coverage expansion for undocumented children. The webinar highlighted key facts about the expansion, the implementation process, the opportunities and challenges, and the new health4allkids.org toolkit to assist communities in preparing for a smooth transition.

Figure 1: Health4All Kids Webinar Partner Organizations

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Key Facts about the Expansion

Currently, undocumented children are only eligible for emergency Medi-Cal (“restricted scope” Medi-Cal). Restricted-scope Medi-Cal just covers emergency medical services whereas “full-scope” Medi-Cal is comprehensive coverage, including preventative services, primary care, vision, dental, prescription drugs, and specialty mental health and substance abuse services. Below are key facts about the expansion:

  •  May 16, 2016 is the scheduled start date
  • Coverage will be retroactive to May 1, 2016
  • All income eligible children up to age 19 (below 266% of the federal poverty level (FPL)) can enroll in full-scope Medi-Cal
  • The state will automatically transfer children with restricted scope Medi-Cal to full-scope Medi-Cal and the children will not have to reapply
  • Children with county-based coverage (i.e., local Healthy Kids programs and county health programs like My Health LA) or the Kaiser Child Health Plan must apply for Medi-Cal unless the child is already known to the Medi-Cal system
  • The same Medi-Cal enrollment rules apply for the expansion as for traditional Medi-Cal children
  • Children newly enrolled in Medi-Cal will have a choice of Medi-Cal managed care health plans, if the option is available in their county
  • Families will pay some premiums if their household income is above 160% FPL.

What Families Need to Know

  • All families should enroll their children in restricted scope Medi-Cal now in order to be transferred to full-scope Medi-Cal on May 16, 2016
  • Families can enroll in restricted scope Medi-Cal with an application assister, by phone, at a county office or county website, or through the Covered California website
  • If a child already has a family member enrolled in Medi-Cal, no new application is needed; families can contact their local county assistance office and get other children in the family added to the case

In addition, families need to know that an undocumented child’s enrollment in the California Children’s Services (CCS) program, a program that provides medical services for special health care needs, will not be affected. These children may retain their CCS specialist under the CCS program. Undocumented CCS children will now be eligible for full-scope Medi-Cal.

Community Opportunities and Challenges

Communities across the state are faced with the challenge of informing and educating families with eligible children about the new coverage opportunity. Community-based organizations (CBOs) and clinics will need to communicate to families about the following:

  • Medi-Cal does not share immigration information
  • Premium costs may apply
  • How the managed care model works and the importance of choosing a health plan

Health4All Kids’ Toolkit

The new toolkit (health4allkids.org) will help organizations achieve a smooth transition for families in their community. In the toolkit, CBOs and clinics can find information (in English and Spanish) to assist families transitioning to Medi-Cal, including key facts about the expansion, how to apply, Deferred Action for Childhood Arrivals (DACA), and details of the enabling legislation, SB 75. The figure below is a screenshot from the Health4AllKids website showing the array of helpful topics found in the toolkit.

Figure 2: Topics under Health4All Kids “Tools for Organizations” Website Tab

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Final Thoughts

The expansion to cover all children has been a long time coming for the health organizations and the advocates who have been working on this for decades. ITUP recognizes and applauds the years of hard work, determination and dedication of all those organizations and individuals who kept the state focused on meeting this basic need for the children of California!

The families of the newly eligible children will find relief in their efforts to ensure their children have the required immunizations and preventive exams children require and access to the health care services they need to get and keep children healthy. ITUP will continue to monitor the progress of California’s efforts to cover all kids. Stay tuned!

Health4All Kids will have a follow-up town hall on May 6, 2016 at 1 pm and a Twitterchat on May 10, 2016 at 11 am.

Link to webinar slides. Link to webinar (will be added once available).