• Description

This report examines enrollment patterns and gaps overall and for specific groups within Medi-Cal and Healthy Families, as well as medical costs after a gap. We use this information to examine the possible effect of the Governor's plan to reinstate Quarterly Status Reports in Medi-Cal. Highlights include:

  • Overall, approximately 50% of newly enrolled children "survive" after 21 months of enrollment in both Medi-Cal and Healthy Families;
  • The sharpest drop in enrollment is seen at the 12-month renewal point, especially for children in Healthy Families and those in the 1931(B) and children's percent programs in Medi-Cal;
  • For children in other Medi-Cal -- especially those who are also receiving food stamps or cash assistance -- the drop is more gradual over time. These families need to renew more frequently to maintain the other social supports and thus, stay in closer touch with county assistance agencies.
  • More frequent renewals will hit hardest children in the 1931(b) and percent programs of Medi-Cal. It is likely that half the children in these programs will be dropped at every renewal period.
  • These families are teetering on the brink of poverty, are likely to be affected by an economic downturn, and may need the support health coverage offers for their children.
  • Costs of medical care are substantially higher immediately after a gap. The longer the gap, the higher the cost afterwards.
  • In Medi-Cal, it is likely that costs saved in the short-term by reducing enrollment using Quarterly Status Reports will be offset by pent up needs later on (or transferred to the safety net in the shorter term).