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San Diego Union-Tribune
September 4, 2005
By Bill Ainsworth
SACRAMENTO--During the past year, ambitious
plans from both the right and the left to cover the state's
estimated 6.6 million people without health insurance have
gone nowhere.
Yet health care advocates haven't given up.
Instead, many are focusing on covering the most vulnerable
segment of the uninsured population -- children.
Before the legislative session ends this week, health care
advocates expect the Legislature to pass a bill that eventually
will cover all of the state's estimated 800,000 uninsured
children under the age of 19.
The legislation creates a dilemma for Gov.
Arnold Schwarzenegger, forcing him to increase the deficit
or turn his back on a plan that seeks a goal he has strongly
endorsed.
The bill is intended as a practical approach
toward reducing the ranks of the uninsured, said one of its
key supporters, Jim Keddy, executive director of the Pacific
Institute for Community Organization, a faith-based group.
Other health insurance proposals have stalled
or been defeated.
In November, voters narrowly rejected a measure
that would have required businesses with more than 50 employees
to provide health insurance for their employees or pay into
a special fund.
This year, the sponsor of a plan favored
by liberal Democrats, which would enact a government-run system
of universal coverage, delayed the bill.
Lawmakers defeated an approach favored by
conservatives that would require individuals to purchase their
own health plans.
"We figured if we were going to
make progress anywhere, it was going to be with children,"
Keddy said. "The public has more sympathy for children
and they don't cost as much to insure. We get federal matching
funds, so we're not doing it alone."
Assembly Bill 772,carried by Assemblywoman
Wilma Chan, D-Oakland, is backed by children's advocacy groups,
the California Medical Association and some business organizations,
including the Los Angeles Area Chamber of Commerce.
The bill would create the California Healthy
Kids Insurance Program in which a single application would
be used for parents seeking insurance from the two main government
programs, Medi-Cal and Healthy Families.
The legislation would improve the application
process, increase outreach, expand eligibility and fund the
14 counties that have children's health insurance plans.
The program would be free for lower-income
parents, who qualify for Medi-Cal. Some of the children's
parents would pay monthly premiums of no more than $23 per
child and $69 per family.
The new program aims to provide relief to
people such as Danyrea Hassan, a San Diego single mother of
three whose children went without health insurance for about
18 months.
At the time, Hassan worked for a small firm
that couldn't afford to cover employees' children. Hassan
said she struggled to find inexpensive medications and treatments
for her 14-year-old son, who suffers from asthma.
"It was expensive paying for the
prescriptions," she said.
Eventually, she went to Tijuana to buy less-expensive
medicine, but she worried that it might not be as effective.
"I was desperate, but you do what
you have to do," she said.
Hassan said her children now are covered
by their father's insurance, but she worries what might happen
if he loses his job.
"I know what it's like when you
have a child with a chronic illness and you can't take him
in for preventive care," she said.
Supporters of the legislation estimate 93,000
children in San Diego County do not have health coverage.
"There's a lot of prevention that
doesn't happen, and it takes a toll," said Stephanie
Gut of the San Diego Organizing Project, which works with
local congregations. "Children lose days at school and
there's a risk factor for the entire community in terms of
communicable diseases."
Gut has been working to try to set up a children's
health plan in San Diego County, similar to those in Santa
Clara, Alameda and Los Angeles counties.
Ruth Riedel, who heads the San Diego effort,
believes it is unlikely to happen because she doesn't think
San Diego County supervisors will approve funding.
Plans in other counties rely on funds from
local government that they use to help win money from foundations
and the state and federal governments, said Riedel, president
of the Alliance Healthcare Foundation.
Money is also a problem for the state.
Most Republicans have voted against the legislation
as it traveled through the Legislature, saying it would cost
too much.
The bill has moved ahead on the strength
of votes from Democrats, who control the Legislature. The
Senate is expected to approve it Tuesday or Wednesday.
Schwarzenegger's administration has indicated
a likely veto. Health and Human Services Agency spokeswoman
Nicole Kasabian Evans said the state's deficit makes Schwarzenegger
uncomfortable with extra spending.
The new program created by the bill would
be phased-in over five years. Eventually, it would cost the
state $300 million.
The bill would allow California to tap more
federal dollars. Under the Healthy Families program, the federal
government pays $2 for each $1 the state contributes.
The bill would expand eligibility for the
Healthy Families program, allowing children in families of
four who earn 300 percent of the poverty level or up to $58,000
a year to qualify.
Currently, children only can qualify if their
families earn 250 percent of the federal poverty level or
$48,000 annually for a family of four.
"Now's not the right time for
this," said Kasabian Evans. "We feel like this
is a political ploy to put the governor in a tough position."
Supporters hope they can win Schwarzenegger's
approval.
In the past, Schwarzenegger has strongly
supported covering children.
During a debate in the 2003 recall campaign,
he said: "We have to make sure that every child is insured.
That is the most important thing."
Kasabian Evans said children's health care
is a priority for the administration, which seeks to expand
Healthy Families by enrolling 125,000 additional children
this year.
Schwarzenegger even broke a pledge to give
schools more money -- which has caused him a major political
problem -- in order to fund health care and other programs.
Supporters of the proposal have tried to
build momentum. In April, more than 3,000 people attended
a community meeting to promote the effort. Some leaders have
used personal meetings to lobby first lady Maria Shriver.
Some backers of the plan worry that putting
pressure on Schwarzenegger might backfire, causing him to
reject later efforts.
Chan, the bill's author, disagrees.
The program would change the application
process for children's health coverage. That is an important
step, she said, but one that has minimal costs for the first
couple of years.
Chan, who leads the Assembly Health Committee,
said the bill will save the state money by helping children
get preventive care so they won't be forced into overcrowded
emergency rooms.
"It's not a ploy," Chan said.
"It's a sincere policy effort to insure all kids."
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