Healthy Families Program on the Chopping Block

Governor Brown and California Legislatures came into an agreement for this year’s state budget to phase out California’s successful Healthy Families medical program, the state-sponsored health insurance program for children, teens, and pregnant mothers. Although some details are still vague, this means an estimated 875,000 children would be required to transition to the Medi-Cal program.

What Happens to Children Covered Under Healthy Families?

  • Children enrolled in Healthy Families will not have to switch to Medi-Cal until January 2013 at the earliest.
  • Families will receive a notification from the state at least two months prior to any changes in health insurance coverage and there will be no gap in coverage during the transitioning.
  • This transition is expected to occur in four phases and the individual switches will vary depending on where the child lives and his or her health plan.

Most importantly, during the phasing out of Healthy Families, children will not lose their health coverage. Medi-Cal provides all the same benefits of Healthy Families coverage as well as improved mental health benefits.

The Issue:

The good news is that Medi-Cal benefits are relatively similar to healthy families. Children will still be able to see the same doctors and get the same treatment under Medi-Cal. Children will continue to have health insurance coverage, but under the Medi-Cal program.

What seems to be the problem? A key concern with eliminating Healthy Families is the patient process of switching health care providers. Since doctors and health providers receive a higher reimbursement rate from Healthy Families than from Medi-Cal, many health care providers will not accept Medi-Cal patients.

Tri-City Health Center Patients:

TCHC accepts both Healthy Families and Medi-Cal, so our patients will not have to worry about denied health care access. With Healthy Families phasing out, there can be an expected increase in new patients under the Medi-Cal program. TCHC will continue to accommodate all of our patients and prepare to serve this future influx of new patients.

The Healthy Families Program will start sending out notices to its members, describing the switch and what to expect, within the next few months. The first phase of this transition will begin in January 2013. Until then, health center advocates will receive updates of Healthy Families and Medi-Cal as TCHC receives more information.

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