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Covered California News & Commentary

Topics of interest to both consumers and agents related to Covered California and the ACA biased in favor of the successful implementation of the Exchange and deliberately apolitical.

Healthy Families Program to be Eliminated

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Healthy Families is California’s version of the Children’s Health Insurance Program (CHIP), which provides health insurance coverage to children whose parents earn more than the Medi-Cal limit, but not enough to make health insurance affordable. California had 1.7 million children in the program as of 2010. One of Gov. Jerry Brown’s budget-cutting moves this year was to end Healthy Families and cover them instead through Medi-Cal. The elimination of the Healthy Families program begins Jan. 1, 2013 with the first phase of the conversion - moving approximately 415,000 children to Medi-Cal managed care plans during the first month. The balance of the children will be moved into managed care over the following 12 months.

Awkward Timing

Folding Healthy Families into Medi-Cal comes at an awkward time for its members. It forces hundreds of thousands of children to change insurers and doctors now and then again a year later. In Jan 2014, the majority of those parents will be obtaining subsidized coverage through Covered California from private insurers, not from Medi-Cal. As a result, children and their parents would be getting their healthcare from different programs, in many cases with separate networks of doctors and hospitals.

Covered California Wants the Numbers

While the Exchange Board and staff have been largely quiet on this issue, the additional enrollments, perhaps as much as 1 million lives, add to their marketing muscle. Covered California, in its role as active purchaser, is about to engage in the initial round of negotiations with health plans over the the cost of qualified health plans to be offered on Covered California.

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