Striking Enrollment Gold in California: Recent Survey Offers Hints

By Cate Bonacini

It’s been a number of years since I moved away from my home state of California, but I still find myself full of pride every time I hear that it has done something well, whether it‘s producing the latest National Spelling Bee Champion or building an excellent public assistance program. The California HealthCare Foundation recently decided to take a look at how well Medi-Cal is working, and who better to ask than the recipients themselves? The report, Medi-Cal at a Crossroads: What Enrollees Say about the Program, provides us with excellent insight into how Californians perceive Medi-Cal, and it gives us clues about the outreach and enrollment challenges the state will face as coverage is expanded. So, what do current enrollees (and parents of enrollees) think? The overwhelming majority (90 percent) think it is either “a very good program” (43 percent) or “a pretty good program” (47 percent). This is good news, since part of the enrollment challenge in 2014 will be to convince people who may be newly eligible for Medi-Cal that it’s a program worth checking out.

Source: Medi-Cal at a Crossroads: What Enrollees Say about the Program, California HealthCare Foundation, May 2012.

More key findings about current enrollees:

  • Enrollees report positive enrollment experiences.  Three-quarters of people say that signing up for Medi-Cal was either very easy or somewhat easy. Most enrollees report positive enrollment experiences like a short and easy to understand application, convenient hours, and friendly workers in the county office, but at least half of enrollees reported long wait times at these offices.
  • People want to enroll online, but few know that this is already an option. While the bulk of current enrollees signed up in county government offices (74 percent), one in five said that they would prefer to sign up online. Although online enrollment has been available in California since 2010, 79 percent of enrollees either did not know this (65 percent) or did not think it was available yet (14 percent).

The report also surveyed those who, based on income, will likely be eligible for Medi-Cal when the expansion to 138 percent of the federal poverty level takes effect. The findings can be summarized in three points:   

  • Most have a positive impression of Medi-Cal. Although a third of those surveyed did not have an opinion about the program, 58 percent believe Medi-Cal is either a very good (24 percent) or pretty good (34 percent) program. While some work will need to be done to educate people about Medi-Cal, very few people who know about the program have a negative opinion about it. The “stigma” issues that are so often associated with Medicaid may not be a significant hurdle in California.
  • Most do not think they will qualify for Medi-Cal. Even though opinions of Medi-Cal are generally positive, many of those who will likely be eligible don’t think that the Medi-Cal expansion will include them (27 percent), or they are unsure of whether they will be eligible (40 percent). Less than a third (27 percent) expect that it will be easy to apply. Messages to educate this group may need to focus on who the expansion will cover and how easy it will be to apply.
  • Some will be comfortable signing up for Medi-Cal online, but they still want to be able to get assistance in person and over the phone. Applying in person remained a popular preference among those likely to be newly eligible (31 percent), but applying by mail/phone or online were also popular (20 percent and 19 percent, respectively). However, when asked how people want to get help signing up, over half wanted to be able to talk with someone in person (52 percent), and almost as many wanted to be able to get help over the phone (41 percent).

Clearly, there is lots of work to do to make sure those who are likely to be eligible for expanded coverage in California (and around the country) know that the coverage expansion is coming, that they are likely to qualify for it, and that enrolling will be easy. Enroll America is hard at work developing a public education campaign to push some of these very messages, and states like California are pursuing their own research to shape public education efforts as well. More on these efforts in California and other states in upcoming blog posts!

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