What California families with young children say about the end of pandemic-era supports

Jan 22

When the COVID-19 pandemic began to take hold in the U.S. in March 2020, Congress temporarily boosted several social support services, including Medicaid (Medi-Cal in California) and SNAP (Supplemental Nutrition Assistance Program, known as CalFresh in California). A federal provision required states to keep all enrollees continuously enrolled in Medicaid in order to receive enhanced federal funding for the program. It also allowed for an increase of at least $95 a month in CalFresh benefits for families to purchase food.

Download the complete fact sheet for direct quotes from survey participants and more.

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The federal government began to “unwind” these protections in spring 2023. Beginning April 1, Medi-Cal enrollees were asked to take steps to renew their Medi-Cal coverage in order to keep their health insurance, after nearly three years of continuous enrollment. Now, Medi-Cal enrollees must have their eligibility redetermined by completing and submitting renewal forms which require, in some cases, proof of income, which can be an obstacle to enrollment for some families. Similarly, in March, CalFresh recipients received the last extra monthly boost to their payment. This change came at a time when families had also been facing increased costs of everyday items, making staples such as eggs and milk more costly than ever.

In this fact sheet we share the voices of California families with young children and the impact of these emergency provisions and their termination. In addition to food and health care assistance, the state also offers assistance in paying for child care for those who qualify. Caregivers also shared with us their interest in receiving those subsidies.

Medi-Cal Enrollment Increased Among Lower-Income Families

In April 2023, the month that continuous Medi-Cal coverage ended, 53% of RAPID-CA participants said they were enrolled in Medi-Cal. In June, that number had increased to 70%.

When we look at Medi-Cal enrollment by income level between April and June, we found a sharp decline in enrollment among higher-income families. There was an increase in lower-income families enrolled in Medi-Cal at this time, but the largest increase was in middle-income families, defined as households with income between 200% and 400% of the federal poverty level.

Enrolled in Medi-Cal, by income levels

Awareness of end of continuous enrollment

The California Department of Health Care Services launched a campaign that ran from February to June 2023 to raise awareness about the termination of continuous enrollment and to encourage beneficiaries to renew their coverage. More than a quarter (27%) of RAPID-CA participants who were enrolled in Medi-Cal were aware of the re-enrollment policies in April 2023 and awareness increased to 75% in June. There were, however, significant racial gaps in awareness. White families enrolled in Medi-Cal were much more likely (97%) to be aware of the re-enrollment policies by June, while 76% of Black families were aware of the change, followed by 64% of families from other racial and ethnic groups, and 59% of Latinx families. RAPID will continue tolearn how families with young children are accessing information about the programs they may be eligible for and participate in.

Lower-income families enrolled in Medi-Cal initially reported much higher levels of awareness of re-enrollment policies, but by June, there was only an 8 percentage point gap between
lower- and middle-income participants.

Renewal of Medi-Cal Coverage

RAPID data also show differences by race in participants’ plans to re-enroll. By June, white parents were much more likely to have already renewed their Medi-Cal coverage than other groups. RAPID will explore factors that may be contributing to these coverage renewal patterns in future surveys.

Awareness of Medi-Cal re-enrollment policy, all participants

Low-income households were initially more aware of the end of extra CalFresh allotments

April 2023 was the first month Californians would have seen a decrease in their CalFresh benefits due to the end of emergency allotments. Earlier this year, RAPID reported that 1 in 5 California households with young children experienced difficulty paying for food in 2023. In the context of high rates of hardship and high cost of living, this decrease in the monthly CalFresh allotment may contribute to persistent hardship and hunger for many families and children.

Awareness of the decrease in CalFresh

In April 2023, 82% of RAPID participants who received CalFresh said they were aware of the decreasing benefit. In June, awareness jumped to more than 98% of parents who receive CalFresh.

In April, lower-income households reported 100% of awareness of the decreased benefit, at 86%, followed by 56% of middle-income households. By June, 100% of both lower- and middle-income households reported awareness of the decreased benefit. These data suggest that parents who receive CalFresh are highly engaged with the program and communications about the monthly benefit.

Awareness of SNAP/EBT benefits decrease, by income level

Californians are interested in receiving child care assistance, but unsure of eligibility

In addition to hearing from parents on social service programs like CalFresh and Medi-Cal, we also asked parents about their use of and interest in financial support to offset child care expenses. Previous RAPID data have shown that 1 in 5 families in California have experienced hardship paying for child care. In California, there are several different state-funded subsidies available, with qualifications for lower-income families, those with foster children, migrants, and more.

Overall, half of survey participants in California said they were interested in receiving public assistance for child care if it was available to them.

About 39% of parents who were interested in child care assistance had not applied for any because they weren’t sure if they were eligible. More than 1 in 4 said they were told they weren’t eligible, and a small percentage said they weren’t able to complete the application or there was another reason that wasn’t listed.

Reasons that interested parents did not apply for child care assistance, all participants

Conclusion

Many California families with young children rely on social service benefits such as CalFresh and Medi-Cal and many are interested in additional support for services such as child care. RAPID data from early 2023, before the pandemic-era expanded benefits were terminated, show that nearly half of California families with young children have had difficulty paying for basic needs, such as food and healthcare. Providing continuous health coverage to parents and young children and increasing the support parents receive to buy food for their families can help reduce the hardship many are experiencing. The termination of these expanded benefits may mean that material hardship will persist for families who are already struggling and increase the rate of hardship among families in the state.