The Low Income Health Program (LIHP) provides counties and public hospitals with partial federal reimbursement for expanding coverage to low-income, uninsured residents. All LIHP enrollees are assigned to a "medical home," primary care clinics where patients receive care tailored to their needs. The combination of coverage expansion and enrollment in medical homes helps patients get the right care, when they need it, in the appropriate setting.
The Low Income Health Program (LIHP) is a coverage program for low-income uninsured adults in California that was included as part of California's Section 1115 Medicaid Waiver. The program builds off and expands the previous and very successful Coverage Initiative that was part of California's previous waiver. The Coverage Initiative provided health care services to over 100,000 adults in ten different counties from 2007-2010, eight of which were in communities where county-owned public hospital systems are at the center of the provider networks. The LIHP is available to all California counties, subject to their ability to provide the matching funds for partial federal reimbursement.
For more information on the Low Income Health Program, please click here
Eligibility and Benefits
The Low Income Health Program is available for uninsured adults between 19- 64 years of age, who earn up to 200% of the Federal Poverty Level, which is roughly $21,700 per year for an individual. Each participating county can establish their own income eligibility limit from 0-200% of FPL, and most counties are establishing income limits based on the number of people they can enroll prior to 2014. The benefits available to enrollees are comprehensive and include preventive, outpatient, hospitalization, prescription and emergency services.
Expanding coverage to hundreds of thousands of uninsured adults generates benefits for patients and their families and public hospital systems. Patients who were previously uninsured, now have access to a wide range of health care services and a team of providers dedicated to working with patients to keep them well and out of the emergency room and hospital. Public hospital systems can provide more coordinated care, can proactively address the health needs of their patients upfront, while receiving partial federal reimbursement for the cost of services.
Enrollment in the Low Income Health Program has already begun in counties that had previous Coverage Initiative programs and a number of other local programs will be off the ground in early 2012.
Preparing for 2014
As leaders in the Low Income Health Program, public hospital systems are at the center of LIHP provider networks, offering comprehensive services in every setting, from primary care medical homes to specialty services, hospitalization, and everything in between. As county facilities, public hospital systems also coordinate with other county providers, including mental health and substance abuse providers and are heavily involved with the planning and administration of LIHPs. To that end, they are actively engaged in efforts to expand coverage through the LIHP to hundreds of thousands of currently uninsured adults in advance of 2014. In addition, they are also working with local stakeholders and enrollees to ensure a smooth transition to health reform and the expansion of Medi-Cal. Since many LIHP enrollees will be eligible for Medi-Cal in 2014, public hospital systems will be working to develop a seamless process for these adults to ensure coordination and continuity of health care coverage so participants within the Low Income Health Program can maintain the same access and level of care.
Please see the following materials on the Low Income Health Program and previous coverage expansion efforts: