Imagine being a parent to a 20-month-old and learning through a developmental screening that your toddler might have autism spectrum disorder. The pediatrician recommends a full diagnostic evaluation and early intervention services. But soon after that screening, you find out your child was dropped from coverage. While you work to re-enroll as quickly as possible, the process takes six months — during which time, your child cannot get any of the necessary follow-up care – care that is critical to their development.
As a mom to a two-year-old, I, like many parents and caregivers, know how crucial it is to be vigilant about our children’s healthcare, especially during their early years. If I found out my child had a condition that needed attention and I did not have the means of helping her, it would be terrifying and heartbreaking.
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Many California parents are currently finding themselves in this situation, as a federal protection that kept Medi-Cal members continuously enrolled in coverage during the Covid-19 pandemic has ended. Policymakers understood that during a pandemic, we cannot risk disrupting the very coverage that enables our kids to get the screenings, support and care necessary to grow up healthy. In the first 4 months without this coverage protection, over 150,000 California children have been dropped from Medi-Cal coverage. What is particularly frustrating is that almost all of those who lost coverage did so unnecessarily–91% of all Medi-Cal disenrollments are due to “procedural” reasons, such as renewal forms not being submitted, questions not answered due to long call wait times or Medi-Cal not receiving required documentation. Three-fourths of children dropped from coverage remain eligible.
California’s Department of Health Care Services has conducted a major outreach campaign to educate families about how to successfully renew their coverage, and has adopted federal flexibilities to make the process easier and more streamlined.
In predicting that the coverage protections during the pandemic would end, advocates such as myself successfully advocated for California to adopt a continuous Medi-Cal coverage policy for children ages 0-5 – avoiding annual renewals during this vulnerable time in their childhood development. For this important protection to become a reality as soon as possible, we now need the Governor to fund and greenlight this policy immediately–in his January 2024 Budget proposal.
Losing coverage — even temporarily — delays medical care, undermining healthy childhood development. In a child’s first five years, the American Academy of Pediatrics recommends 14 well-child visits for preventive care, immunizations and tracking developmental milestones, which can identify conditions like autism. Healthy development is harder to achieve when coverage is disrupted.
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Continuous coverage policies advance health equity by removing enrollment barriers in Medi-Cal. Long-standing, structurally racist policies and practices have created an environment where families of color experience a significantly greater degree of instability in employment, income and housing, which leads to instability in health coverage. By removing enrollment barriers in Medi-Cal, continuous coverage policies offer that stability to millions of families of color who disproportionately rely on Medi-Cal. Today, 70 percent of all children with Medi-Cal are children of color.
Delaying implementation of California’s continuous coverage policy for young children is an enormous missed opportunity. But it doesn’t have to be this way. Oregon provides a model for California, as the first state to provide multi-year continuous coverage for kids just as the federal continuous coverage protection ended. Seven other states including California have this continuous coverage protection in development. Let California continue to lead the nation in advancing health equity.
A commitment to building a California for All behooves a bold commitment to the health of our youngest. We urge the Governor to fund and greenlight continuous Medi-Cal coverage for young children, ensuring that all children in California have no gaps in access to health care during their critically important early childhood development. It’s time for the government to take action and prioritize the well-being of our children by funding this crucial protection. Together, let’s safeguard the health and future of California’s children by removing barriers to health care and health equity. Government leaders have shown the desire to keep kids covered, and now they have the roadmap to make that vision a reality.
Photo: Suriyapong Thongsawang, Getty Images
Mayra E. Alvarez is president of The Children’s Partnership, a nonprofit advocacy organization working to advance child health equity through policy, research, and community engagement. In 2021, she was named by President Biden to the Covid-19 Health Equity Task Force. Ms. Alvarez serves on the Covered California Board of Directors and the California Early Childhood Policy Council, as well as the Mental Health Services Oversight and Accountability Commission (MHSOAC). Previously, she served at the U.S. Department of Health and Human Services during the Obama-Biden administration, including at the Centers for Medicare and Medicaid Services, the Office of Minority Health, and the Office of Health Reform. She also served as a Legislative Assistant in the US Senate and US House of Representatives. A native of California, she graduated from the School of Public Health at the University of North Carolina at Chapel Hill and the University of California at Berkeley.
