We explored reasons why California's urban American Indians/Alaska Natives (AI/ANs) participate or don't participate in the State's public health insurance programs, MediCal and Healthy Families. We used a multi-method approach to address the research question, conducting key informant interviews with 10 American Indian health policy/health care leaders, focus groups with 5 groups of urban AI/ANs, and an in-person survey with 200 urban AI/ANs who were either members or eligible for the public health insurance programs. The settings were Los Angeles, Orange County, Oakland, Sacramento, and San Diego, CA. Analysis included qualitative content analysis, the Chi square test, and logistic regression analysis. During the key informant interviews and focus groups, commonly noted barriers to enrollment were 1) lack of awareness about the programs - a majority of focus group participants knew nothing about the Healthy Families program; 2) lack of awareness of Healthy Families staff that children in federally recognized tribes were not required to make co-payments; 3) the onerous enrollment process; and 4) disrespectful treatment by Healthy Families and MediCal eligibility workers. Some of the suggestions for addressing these barriers included 1) educating eligibility workers about issues specific to AI/ANs; 2) developing culturally sensitive advertising about the program; 3) streamlining the application process; and 4) making the application process more easily understood. Results of the 200-person survey are pending and will be presented at the conference. In conclusion, many barriers exist to AI/AN participation in California's public health insurance programs. Culturally sensitive approaches are needed to overcome these barriers.
Learning Objectives: At the end of the presentation, attendees will recognize barriers to participation in public health insurance programs and and will be able to assess potential policy options to overcome them.
Keywords: Access to Health Care, Insurance-Related Barriers
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.