Los Angeles Healthy Kids Improves Access to Care and Health Status

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Abstract

The Los Angeles Healthy Kids program provides health insurance to low income children in the county who have no other source of coverage (including undocumented children and children above the income limits for Medi-Cal and Healthy Families).  These findings from a longitudinal survey of parents of young children in the program indicate that access to medical and dental care for enrolled children increased dramatically over time, use of the emergency room went down, and parents perceived improvements in the health status of their children. This analysis is one piece of a broader Urban Institute evaluation of the program.

Introduction

Findings from a longitudinal survey of parents with children enrolled in the Los Angeles Healthy Kids program indicate that access to medical and dental care for enrolled children increased over time, while unmet needs for care decreased. In addition, parents report improvements in the perceived health status of their children.

Background

Launched in July 2003, the Healthy Kids program in Los Angeles aims to extend universal coverage to children in families with incomes below 300 percent of the federal poverty level who are ineligible for Medi-Cal or Healthy Families. With funding from First 5 LA, Healthy Kids initially covered children 0 through 5 years old. Additional funding enabled expansion of the program in May 2004 to include children 6 through 18 years old. Enrollment for this age group was rapid and funding limited, requiring that a hold be placed on enrollment of children 6 through 18 years old in June 2005. The hold remains in place today.

The Healthy Kids program includes intensive community-based outreach, enrollment assistance, and comprehensive coverage of preventive, primary, and specialty care benefits, including dental and vision services. Services are administered by L.A. Care Health Plan on a prepaid, capitated basis. Families with incomes above 133 percent of the federal poverty level are required to pay an incomeadjusted premium, and all enrollees are responsible for some co-payments at the point of service.

This brief presents results from two waves of parent surveys conducted as part of the Los Angeles Healthy Kids program evaluation designed to measure the impact of the Healthy Kids program on perceived and realized access to care for established and new enrollees. The findings summarized here are limited to parents of children age 1 to 5 and focus on how the program affects access to care and health status outcomes. First 5 LA contracts with the Urban Institute and its partners—the University of Southern California, the University of California at Los Angeles, Mathematica Policy Research, Inc. (MPR), and Castillo and Associates—to conduct the evaluation.

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