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San Francisco Chronicle
May 1, 2005
San Francisco Chronicle Editorial
Words should mean something.
"We have to make sure every child in
California is insured," candidate Arnold Schwarzenegger
declared while debating then-Gov. Gray Davis on Sept. 24,
2003. "That is the most important thing. I'm very passionate
about children's issues. It is very important because they
cannot fend for themselves. It is really terrible."
He went on to criticize Davis for not being
aggressive enough in enrolling children in Healthy Families,
the federally subsidized program providing insurance to low-income
children.
But within weeks of taking office as governor,
Schwarzenegger proposed imposing a cap on enrollments in the
Healthy Families program, virtually ensuring ever longer waiting
lists.
Schwarzenegger eventually backed off on his
plan to cap Healthy Families. His is now trying to revive
a program from the Gov. Pete Wilson era that would pay $50
to "application assistants" to sign up new enrollees
in Healthy Families. And his Health and Human Services Secretary
Kim Belshé says she is working on a plan to make it
even easier for kids to enroll in the program. Health coverage,
Belshé told us, "is an important investment we
must make in our kids, to insure that they do well in school
and well in life."
After 18 months with Schwarzenegger in office,
nearly 1 million children in California are still without
health insurance. Meanwhile, the governor has embraced tangential
issues such as teacher tenure and merit pay that were not
focal points of his gubernatorial campaign.
It is not too late. The governor has a chance
to fulfill his campaign pledge by supporting legislation introduced
by Assemblywoman Wilma Chan, D- Oakland.
Designed to insure all children in California,
Chan's legislation (AB772) will extend coverage to children
from families with incomes of up to three times the federal
poverty level (Healthy Families only covers those from families
with incomes 2 1/2 times the federal poverty level). Cost
estimates to the state range from $112 million to $330 million.
State funds will be matched by hundreds of millions of dollars
in federal funds.
Of all the numerous health proposals being
debated in Sacramento, Chan's bill has the best chance of
passing -- mainly because it is doable, it is not outrageously
expensive, and because it moves the state toward a goal that
both Democrats in the Legislature and the governor have already
embraced.
Insuring all children is not a radical idea.
More than 90 percent of California's children already have
some kind of health coverage. Even as the number of adults
without health insurance continues to rise, the number of
uninsured children in California has declined over the past
several years.
This turnaround is a result of the remarkable
success of a series of largely unheralded county programs.
In addition to aggressively recruiting kids who are eligible
for Healthy Families and Medi-Cal, these programs also offer
insurance to kids from families with incomes that make them
ineligible for existing programs
As result, 97 percent of children in Santa
Clara County now have some form of health insurance through
its pioneering Children's Health Initiative which began 2001.
In San Francisco, officials say the percentage is 99 percent.
Eight other counties have initiated similar programs, and
another 18 also are exploring doing so as well.
These results have been achieved despite Sacramento's
efforts, not because of them. In many instances, the counties
have had to contribute their own funds -- San Francisco, for
example, contributes more than $5 million from its general
fund. Santa Clara County has raised $3 million from private
foundations for its effort.
Some might conclude that because of the success
of county-level programs, there is no need for a statewide
program. In fact, county programs are showing that providing
coverage for all children is a realistic goal -- and are providing
a model for how it can be done.
What's more, funds for county-level programs
could dry up at any point. In addition, many counties -- mostly
rural ones -- don't have the capacity or resources to establish
their own insurance programs, even if they had the will.
This is not a matter of choice. One way or
another, Californians end up paying the cost of health care
for children. Those without insurance end up in public emergency
rooms funded by taxpayers, or with expensive medical conditions
that could have been prevented.
Secretary Belshé advocates taking
what she calls "strategically incremental" steps
to deal with the problem. We think that with the goal of
insuring all of California's children now in sight, a more
aggressive approach is in order -- one Schwarzenegger seemed
to offer when he took office. All parties should unite behind
the Chan bill. If there are parts they don't like, start
negotiating. But just get the job done.
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