Parents' Opinions of the Los Angeles Healthy Kids Program Remain High Despite Recent Challenges

The text below is an excerpt from the complete document. Read the full report in PDF format.

Abstract

A second series of focus groups with parents of children enrolled in the Los Angeles Healthy Kids program found that opinions of the program remain favorable despite its recent fiscal challenges. Healthy Kids had provided comprehensive, affordable coverage to nearly 45,000 poor children from birth through age 18 until mid-2005, but funding shortfalls led the program to cap enrollment for older children and enrollment levels for all children subsequently slipped. Still, the program remains highly valued by parents for providing high quality, comprehensive coverage and parents report good access to linguistically appropriate care and affordable out-of-pocket costs.

Introduction

During its first four years, the Los Angeles Healthy Kids program grew to be, by far, the largest Children’s Health Initiative coverage program in California. Since its launch in 2003, outreach efforts resulted in the enrollment of nearly 45,000 very poor, primarily Latino, and primarily noncitizen children into coverage. A series of focus groups conducted in 2005 with parents of children enrolled in Healthy Kids revealed their strong praise for the program; parents said that the program was easy to apply for, its benefits covered the services their children needed, that access to care was good, that cost sharing was affordable, and that the coverage gave them a strong sense of security and peace of mind (Hill et al. 2006). . These positive findings were reinforced by findings from a longitudinal household survey of a representative sample of parents of Healthy Kids enrollees. The findings documented that coverage under the program was associated with numerous positive and statistically significant benefits, including improved access to usual sources of health and dental care, improved use of health and dental care, improved confidence among parents that they can meet their children’s health care needs without financial hardship, and improved health status, among others (Howell et al. 2007).

But this proven-effective program has also faced serious challenges during its implementation, mostly related to financing. As early as the spring of 2005, resources supporting premiums for children ages 6 through 18 began running short, and an enrollment “hold” was implemented in June of that year. A waiting list of prospective enrollees was established and maintained until the end of March 2006, at which point it was closed. And despite the fact that funding for younger children ages 0-5 remained stable, enrollment levels for children of all ages began to level off and then drop, as outreach workers struggled to market a program that could only serve a subset of younger children.

The Los Angeles Healthy Kids Program Evaluation—directed by The Urban Institute with partners the University of Southern California (USC), the University of California at Los Angeles (UCLA), Mathematica Policy Research, Inc., and Castillo & Associates—continues to monitor the implementation of Healthy Kids and assess its impacts on the target population and systems of care for children. As part of the evaluation, a second round of focus groups was conducted in the spring of 2007. These focus groups primarily involved parents of children enrolled in Healthy Kids and explored the extent to which they continued to view the program as meeting their and their children’s needs. Among the issues explored were family background and demographics; experiences with outreach, enrollment, and renewal; experiences with accessing health, dental, developmental, and specialty care; perceptions of cost sharing; and overall opinions of Healthy Kids. However, focus groups were also conducted with parents of children who were placed on the Healthy Kids waiting list, parents of children who were disenrolled from the program, and parents of children that were referred to other sources of coverage because Healthy Kids enrollment was closed. Through these groups, we hoped to learn more about how the program’s fiscal challenges were affecting children and the parents caring for them.

(End of excerpt. The entire report is available 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.

Usage, posting and reprint of materials on the UI web site:

Most publications may be downloaded free of charge from the web site in PDF format. This information may be used and copies made for research, academic, policy or other non-commercial purposes. Proper attribution is required.

Copyright of the written materials contained within the Urban Institute website is owned or controlled by the Urban Institute. Posting UI research papers on other websites is permitted subject to prior approval from the Urban Institute—contact paffairs@urban.org.

If you are unable to access or print the PDF document please contact us or call the Publications Office at (202) 261-5687.