From Healthy Families to Medi-Cal

By Thomas Cazneau

California is ending Healthy Families. This is due to a budget deal between Governor Brown and Democratic lawmakers. It’s designed to cut health insurance costs and save other health programs. At the moment, there are about 900,000 kids in the Healthy Families program. It is expected that moving all of these children to Medi-Cal will save $72 million a year by 2015.

Moving to Medi-Cal could be a bit of an uncertain journey based on the changes that need to be made. Below is information regarding how Medi-Cal affects families now and how it could affect children in 2014, the year when the Affordable Care Act goes into full effect.

How Medi-Cal Affects Families Now
Medi-Cal currently offers health coverage to California’s poorest residents. Below are some of the concerns that some of these families may have when switching to Medi-Cal.

      • Some are worried that Medi-Cal will be very expensive to their current Healthy Families plan, because current Medi-Cal rates are considerably high. Some parents have even been quoted as much as $1300 per month, per child, because of how much they make at on their paycheck, while through Health Families, they can currently get all of their children enrolled for as low as $14 per month.


      • Even if a child had a pre-existing condition, Healthy Families does not tack on a surcharge to their health insurance premium. Some parents are worried that switching to Medi-Cal could require a very high premium if their children have pre-existing health conditions.


    • Almost half of the 900,000 children on Healthy Families are Latino children. Families that do not speak English are worried that Medi-Cal won’t have the resources they need to understand the health insurance transition properly.

How Medi-Cal Could Affect Children in 2014
Like many other health insurance entities, Medi-Cal is also making changes to its system in order to comply with the requirements and expected results of healthcare reform.

      • By 2014, it’s expected that Medi-Cal premiums will be very similar to those of Healthy Families.


      • Medi-Cal reimburses their doctors and staff at a lower rate than Healthy Families, and some of these doctors may not be able to continue business as usual if Medi-Cal does not pay them an amount that feels sufficient. Some physicians may choose to limit the amount of patients they receive in order to maintain their hospital budget and needs. This in turn could force some families to find different doctors for their children.


    • Medi-Cal is prepared to take on the number of Latino families being transferred from Healthy Families. According to Toby Douglas who leads California’s Department of Health Care Services – which oversees Medi-Cal – their “proportion of individuals on the Medi-Cal program that are Spanish speaking or Latino descent are the same as those on Healthy Families”. He also states that 90 percent of the providers who work in Healthy Families also participate in the Medi-Cal program. So these providers should continue to see the same children when they transition, making these changes hopefully more palatable.

These are some of the main ways that healthcare reform could affect children who will be transferred from Healthy Families onto a Medi-Cal plan, come 2014. If you would like to discuss alternative plan options, please contact us at 1-800-514-0958. We would be happy to assist you in your healthcare transition.

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