Report: Some Medi-Cal Plans Shortchange Kids

Suzanne Potter | California News Service
A new report finds that fewer than half of kids on Medi-Cal get an annual check-up. Photo Credit: Semevent/Pixabay

SACRAMENTO, Calif. — California spends $4 billion – $5 billion a year on health care for low-income kids, but some of the plans are falling down on the job, according to a new report out this week.

Researchers from the nonprofit Children Now say 40% of Medi-Cal health plans don’t meet minimum standards, and 70% don’t do enough to ensure parents can access care for their kids. Mike Odeh, director of health policy at Children Now, said some counties have better plans available than others.

“That fundamentally means that where a child lives and which plan they’re enrolled in determines whether or not they get the care they need,” Odeh said. “The way it should work is that every child in Medi-Cal gets the care that they need, especially the preventive and primary care that is guaranteed under law.”

For example, in most northern California counties, less than 10% of babies get a developmental screening.

The Newsom administration is about to start negotiating contracts for plans that would take effect in 2024. Advocates want the state to make future payments contingent on better performance.

Odeh said he would like the state to set a mandatory minimum spending level per child for preventive care – and press for real results.

“We could provide incentives on plans that improve health outcomes for kids or reduce health disparities,” he said. “And we need to hold health plans accountable, which means meaningfully making monetary consequences tied to whether or not health plans fall below minimum performance standards.”

Parents can find out how well their county’s health plan is doing by checking out the report, which is available on Children Now’s website.