Valley families need continuous Medi-Cal coverage as an investment in the future
For families of color living in the Central Valley, the pandemic has meant higher rates of food, job, and housing insecurity, as well as higher rates of illness and death than other parts of the state. It’s meant increased isolation and stress, with parents struggling to find child care since their go-to options have shut down. Existing inequities and racism in the health-care system, including barriers to adequate coverage and vaccine access, have intensified.
Well-child visits and immunizations in California are down 24% and 40%, respectively, during the pandemic. That’s why it’s never been more important to ensure families can access health care, especially families who rely on Medi-Cal, the state’s Medicaid program to provide health insurance to low-income individuals.
With a public health emergency in place, every family on Medi-Cal has coverage through 2021, so they don’t need to re-enroll. This protection means Medi-Cal continues to provide secure and comprehensive health care coverage for 74% of children ages 0-5 years in Fresno County. In fact, Medi-Cal is the predominant form of health coverage for young children throughout the Central Valley: 77% in Merced County, 86% in Madera County, and 80% in Tulare County.
However, in 2022 when the public health emergency is lifted, Medi-Cal will revert back to the status quo, whereby parents — in fact all Medi-Cal enrollees — will need to proactively reapply for coverage, and that could put toddlers and new parents at risk of losing it. In fact, about a third of children with Medi-Cal could lose their coverage after the required annual renewal period. Without action, toddlers might not be able to get their well-child visits, vaccinations or developmental screenings, if their parents do not accurately complete the renewal form in time. Why can’t Medi-Cal coverage be as seamless as employer coverage, at least for our youngest children, when regular doctor visits and screenings are so important for their healthy development?
We need state leaders to truly support families during a challenging time and make a smart investment for our future by permanently changing the rules so Medi-Cal continues for 12 months postpartum and children are covered continuously up to age five.
Families won’t magically be out of the woods in 2022. Some families will have moved multiple times, tracking seasonal work, fleeing unsustainable rents, or seeking help with child care. These conditions contribute to what experts call “churn,” or cycling on and off Medi-Cal. It is one example of systemic racism within our health care system, requiring families of young children, primarily families of color, to re-enroll and prove they remain eligible.
The remedy is continuous Medi-Cal coverage for young children and people who recently gave birth. Taking this step will prevent gaps in coverage during a critical time for young children and primary caregivers as well as improve maternal and child health outcomes for years to come.
Continuing Medi-Cal coverage will move California towards health equity for young children and mothers. Medi-Cal is the predominant form of coverage for children of color ages 0-5, including Latino (66%), Black (56%) and American Indian/Alaska Native (71%) children.
The science is clear on how important these time periods are for women and very young children. One-third of all maternal deaths occur a week to a year after pregnancy ends, and one in seven women experience symptoms of postpartum depression in the year after giving birth. Mood and anxiety disorders are the most common perinatal complication, but only one in five who suffer receive treatment. For children, brain development is most rapid in the first five years; investing in children when they’re young yields the greatest returns. With California ranked 40th among states in providing preventive care for young children, it’s clear we need more structures to support their health care — including better access.
Returning to the previous Medi-Cal enrollment rules is reverting to the status quo and keeping in place policies that don’t center health equity for children and families. We can and must do better. Continuous Medi-Cal coverage is an investment in our future. Our postpartum women and our very young children deserve it.