Los Angeles Healthy Kids Program Gets a Healthy Start

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Abstract

The Los Angeles Healthy Kids program extends health coverage to uninsured children from birth through age 18 in families with income below 300 percent of the federal poverty level who are ineligible for Medicaid or SCHIP. Results from the first case study report on Healthy Kids implementation indicate that the program is off to a very positive start. Researchers found that the program's effective community-based outreach and simplified enrollment have fueled strong enrollment, its benefits package and managed care provider network were carefully designed to meet the needs of vulnerable children, and that Healthy Kids has been implemented smoothly.

Introduction

The first case study of Los Angeles Healthy Kids finds that the program is off to a very positive start. Researchers found that the program was thoughtfully planned by a diverse group of policymakers, health providers, county administrators, and advocates. Effective community-based outreach and simplified enrollment have fueled strong enrollment. Plus, the benefits package and managed care provider network were carefully designed to meet the needs of vulnerable children. These results bode well for the roughly 45,000 vulnerable children who have signed up for the program's health insurance coverage.

This brief highlights the key findings from a case study based on in-depth interviews conducted with over 50 stakeholders, including policymakers, public and private providers, county health and social services administrators, health and dental plan officials, child advocates, health policy researchers, and community-based organizations involved with outreach, and supplemented by process measures.

Planning and Design

The Los Angeles Healthy Kids program was implemented in July 2003 to extend health coverage to uninsured children from birth through age 5 in families with income below 300 percent of the federal poverty level (FPL) who are ineligible for Medi-Cal or Healthy Families. Supported initially by an allocation of $100 million from First 5 LA, the program was expanded in May 2004 to cover all uninsured children through age 18 with additional funds raised by the Children’s Health Initiative (CHI) Coalition of Greater Los Angeles.

The Healthy Kids Advisory Committee, selected to include a multidisciplinary group of 40 experts, conducted a thorough and systematic review of policy options for Healthy Kids during the fall of 2002 and spring of 2003, and ultimately designed a program much like Healthy Families (California's State Children's Health Insurance Program) and those of other county Children's Health Initiatives. It includes, however, key components uniquely tailored to better meet the needs of the target population in Los Angeles, such as no premium payments for families in the lowest income band (those at or below 133 percent of FPL), a "premium assistance" program for families that cannot afford to pay Healthy Kids cost sharing, and a "quality enhancement" component to improve the quality of behavioral health and developmental services in Los Angeles County.

Note: This report is available in its entirety in PDF Format.

The nonpartisan Urban Institute publishes studies, reports, and books on timely topics worthy of public consideration. The views expressed are those of the authors and should not be attributed to the Urban Institute, its trustees, or its funders.

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