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This Article Figures Only Full Text Full Text (PDF) All Versions of this Article: AJPH.2006.088690v1 97/4/738    most recent Submit a response Purchase Article View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via ISI Web of Science (1) Citing Articles via Google Scholar Google Scholar Articles by Stevens, G. D. Articles by Cousineau, M. R. Search for Related Content PubMed PubMed Citation Articles by Stevens, G. D. Articles by Cousineau, M. R. Related Collections Other Child and Adolescent Health Insurance Other Health Financing Health Policy Access to Care Public Health Practice

Gregory D. Stevens, PhD, MHS, Kyoko Rice and Michael R. Cousineau, DrPH

The authors are with the Center for Community Health Studies, Department of Family Medicine, Keck School of Medicine, University of Southern California, Alhambra.

Correspondence: Requests for reprints should be sent to Gregory D. Stevens, PhD, MHS, Center for Community Health Studies, University of Southern California, 1000 S Fremont Ave, Bldg A7, Room 7411, Alhambra, CA 91803 (e-mail: gstevens{at}usc.edu).

Objectives. Many county coalitions throughout California have created local health insurance programs known as Healthy Kids to cover uninsured children ineligible for public programs as a result of family income level or undocumented immigrant status. We sought to gain an understanding of the experiences of these coalitions as they pursue the goal of universal coverage for children.

Methods. We conducted semistructured telephone-based or in-person interviews with coalition leaders from 28 counties or regions engaged in expansion activities.

Results. Children’s Health Initiative coalitions have emerged in 31 counties (17 are operational and 14 are planned) and have enrolled more than 85000 children in their health insurance program, Healthy Kids. Respondents attributed the success of these programs to strong leadership, diverse coalitions of stakeholders, and the generosity of local and statewide contributors. Because Healthy Kids programs face major sustainability challenges and difficulties with provider capacity, most are cautiously looking toward statewide legislative solutions.

Conclusions. The expansion of Healthy Kids programs demonstrates the ability of local coalitions to reduce the number of uninsured children through local health reform. Such local programs may become important models as other states struggle with declines in employer-based coverage and increasing immigration and poverty rates.