For Young Californians, More Health Insurance Does Not Mean Better Health Care
There seems to be a contradiction. How can children's advocacy groups give California an A-minus grade when it comes to providing children with the health insurance they so desperately need, and a D+ grade when it comes to universal healthcare and accountability?
For Children Now evaluators, these assessments do not contradict each other. Reflects the current situation. Having health insurance for a child does not mean they will get the care they need.
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“This is not a new story, but it is what is happening,” said Kelly Hardy, director of health and research at the organization, which is working to develop state legislative and administrative solutions for the 13.7 million Californians ages 0 to 26. .
“We should appreciate the great efforts California is making to provide protection for children, because in the past 20% of California children were uninsured [compared to 3% today],” Hardy said. “But this is just the first step. There are still many more steps to take.”
The results are included in the advocacy group's 2024 California Children's Report Card, the final category that assesses children's conditions in areas such as health, education, family support and child well-being. Using existing metrics and consulting with experts and coalition partners, Children Now has conducted assessments every two years for more than three decades. The group says this is done primarily so they can provide information to lawmakers and the California governor's administration about what its supporters see as a roadmap for the development and well-being of young people in the state.
The latest figures from Children Now show that the country is barely hanging on. Of the 33 key youth factors on which California's rankings are based, nearly half the state received a grade of C-minus or lower. It scored better than a “C” on only one of nine issues under the general heading “Health.”
Now this is not just a mental exercise for kids. The organization is working with lawmakers to develop a bill that could change the fate of many young people in California, with a primary focus on low-income children and children of color. In California, about 47% of those under 26 are Latino, the largest number ever.
In recent years, states have made significant progress in the area of youth insurance. Medi-Cal, the state's version of Medicaid, covered 5.7 million children in California before redistricting, and Gov. Gavin Newsom expanded the program to accept more young people regardless of their immigration status. The state is making insurance more accessible to thousands of families through Covered California starting this year.
But when researchers at Children Now looked into the question of whether young people can get the services they need when they need them, they found that the country needs them. In 2021, more than half of the state's managed care plans fell below minimum performance levels for, among other things, immunizations, obstetric visits and pediatric health care. Since the state pays these plans to coordinate and provide Medi-Cal services, this is a red flag.
“Ultimately, the burden is on the state of California,” said LeShawn Francis, senior director of behavioral health at the advocacy group. “Young people have a contractual obligation to ensure they get the care they are promised through health insurance coverage, and they are not getting it. This doesn't happen with Medi-Cal, but it also doesn't happen with commercial insurance. "
Health care providers in the state also lag in providing mental health services, a fact that applies to all age groups but is most acutely felt among California's youth. Between 2016 and 2020, Annie E. According to data analyzed by Casey, the percentage of California children ages 3 to 17 diagnosed with anxiety or depression has increased by 70%. Only South Dakota experienced a sharper increase during that period.
Children's Now gave the state a D+ grade in mental health care. “When families are able to get help from children's mental health services, schools, doctors, and community organizations, this is due to persistence, privilege, and luck, not because of a comprehensive system,” the report's authors wrote.
Francisco was part of a coup attempt in 2023, when Children Now sponsored a bill that would have provided automatic appeals at the state level if someone 26 or younger did not receive mental health treatment. This proposed law met with strong opposition from the health care industry, and the state's Department of Managed Health Care concluded that implementing the law would cost tens of millions of dollars. The bill was withdrawn by the House Appropriations Committee.
In 2024, said the bill's author, a state senator. Scott Wiener (D-San Francisco) would implement a similar measure. This time, the bill specifies that only denials of emergency or life-threatening services are automatically appealed to the state, and all other denials become automatic appeals to the service provider, Francis said. This would shift much of the financial burden away from health plans and states.
Children Now organizers also hope to maintain education funding channels. California spends 3% of its economic output on K-12 education, below the national average, and the agency said the state ranks 43 out of 50 in racial and ethnic achievement gaps. But the state's $68 billion budget deficit raises doubts about any spending increases.
“What we're talking about is not something that anyone can figure out,” Francisco said. At last count, states had a lot to talk about, but the budget was an entirely different matter.
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