Health care access promotes the early detection and effective management of chronic conditions as well as disease prevention and limits costly emergency room visits and hospitalizations.

Data Highlights

Having health insurance coverage does not necessarily guarantee access to quality services. Although roughly 9 out of 10 California children have health insurance, approximately 2.2 million (26%) have plans that do not adequately cover needed pediatric services.

Access to quality health care, in combination with healthy social and environmental factors, can help control chronic conditions such as asthma. Children with poorly controlled asthma are more likely to visit the emergency room, be hospitalized and/or miss school. Last year roughly 129,000 (52%) children with asthma missed some school or day care due to symptoms, causing approximately 1.2 million absences that resulted in missed learning opportunities and reduced school funding.

Timely access to basic health care services – including recommended immunizations and dental, mental, vision and hearing care – is essential for helping children succeed in life. In 2013, over 400 low-income children with autism spectrum disorders were unable to access critical behavioral health services after their mandated transition from Healthy Families to Medi-Cal coverage. Moreover, Medi-Cal does not cover these behavioral therapies; since approximately 3.6 million children are enrolled in Medi-Cal and an estimated 1 in 88 children have an autism spectrum disorder, therefore too many children in Medi-Cal have no access to these life-changing behavioral therapies.

Figure: National Medicaid spending
(click to enlarge image)

Pro-Kid Policy Agenda

California should promote children’s timely access to the complete range of recommended health care services, including preventive screenings, immunizations and dental, mental, vision, hearing and specialty care. The state should leverage federal dollars from the federal health care reform law’s prevention and public health fund to increase the availability of preventive health care services. In addition, the state should educate the public about the health care reform provision which eliminates copays for many preventive services and educate and inform parents about the importance, recommended timing and availability of immunizations and screenings.

Figure: Recommended preventive medical exams
(click to enlarge image)

Momentum

As a result of federal health care reform, children will have access to 10 “essential health benefits” regardless of their health plan. 1 of the 10 categories of benefits is pediatric services, including dental and vision care.

Tele-health (the delivery of health-related services and information via telecommunications technologies) is emerging as a key way to connect patients to their providers and can be an especially crucial option for children in rural and other under served areas to access care. The federal health care reform law encourages the use of tele-health systems as a way to increase access to coordinated care.