Health Advice



Hours on hold, limited appointments: Why California babies aren't going to the doctor

Jenny Gold, Los Angeles Times on

Published in Health & Fitness

LOS ANGELES -- Maria Mercado's 5- and 7-year-old daughters haven't been to the doctor for a check-up in two years. And it's not for lack of trying.

Mercado, a factory worker in South Los Angeles, has called the pediatrician's office over and over hoping to book an appointment for a well-child visit, only to be told there are no appointments available and to call back in a month. Sometimes, she waits on hold for an hour. Like more than half of children in California, Mercado's daughters have Medi-Cal, the state's health insurance program for low-income residents.

Her children are two years behind on their vaccinations. Mercado isn't sure if they're growing well, and they haven't been screened for vision, hearing or developmental delays. Her older daughter has developed a stutter, and she worries the girl might need speech therapy.

"It is frustrating because as a mom, you want your kids to hit every milestone," she said. "And if you see something's going on and they're not helping you, it's like, what am I supposed to do at this point?"

California — where 97% of children have health insurance — ranks 46th out of all 50 states and the District of Columbia for providing a preventive care visit for kids 5 and under, according to a 2022 federal government survey. A recent report card from Children Now, a nonprofit advocacy group, rated California a D on children's access to preventive care, despite the state's A- grade for ensuring children have coverage.

The majority of California's youngest residents — including 1.4 million children ages 5 and under — rely on Medi-Cal, an infrastructure ill-equipped to serve them. The state has been criticized in two consecutive audits in the past five years for failing to hold Medi-Cal insurance plans accountable for providing the necessary preventive care to the children they are paid to cover.


In a written response to questions from The Times, the Department of Health Care Services, the state agency in charge of the Medi-Cal program, said "improving children's preventive care is one of DHCS' top priorities," and that the agency has recently addressed most of the shortcomings identified in the audits.

The department's focus on the pandemic slowed action on the audit findings, the response said. State healthcare officials have since begun to more harshly fine plans that don't provide adequate care and substantially boost payments to pediatricians to help increase access.

But information released publicly this month by the department suggests serious problems remain.

"In the whole scheme of the U.S. health system, I hate to say it, the youngest kids are always the ones that are overlooked," said Dr. Alice Kuo, a pediatrician and health policy professor at UCLA.


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