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Palm Beach Post
September 11, 2005
By Phil Galewitz
SAN JOSE, Calif.--In the heart of Silicon
Valley, the message is a simple one to the low- to moderate-income
parents of children without health insurance: Sign up your
child for the Santa Clara Family Health Plan and your son
or daughter will be covered. No matter what.
Unlike the dizzying array of restrictions
with most state and county child health insurance programs,
Santa Clara County's Healthy Kids program has some of the
easiest eligibility requirements in the nation. Families can
have incomes as high as three times the federal poverty level
($58,000 for a family of four) and still qualify for health
benefits. Moreover, the only requirements are to live in the
county and have no other health coverage.
Launched in 2001, Santa Clara's privately
financed Healthy Kids program has enrolled 30,000 children,
reducing the number of uninsured children in the county to
about 15,000 from 71,000. A big reason for the drop is that
when parents apply to Healthy Kids, the program increasingly
finds that children are qualified for Medicaid or the State
Children's Health Insurance Program. Counting these programs,
the Santa Clara initiative has extended health coverage to
more than 77,000 children.
Almost immediate dividends
Getting children covered by health insurance pays almost immediate
dividends. A study by the research group Mathematica Policy
Research found Healthy Kids members are nearly twice as likely
to report having a regular doctor to go to.
For fathers such as Alberto Oliva, 37, of San Jose, the Healthy
Kids program is the only way he can get medical insurance
for his 4-year-old son, Alberto Jr.
"I greatly appreciate it,"
Oliva said recently when renewing his son's coverage in the
Healthy Kids program at an office just south of San Jose.
Oliva, who cleans pools, can't get health
insurance from his employer and he makes too much to qualify
for Medicaid.
Children enrolled in Healthy Kids get to
choose from the same large network of area doctors and hospitals
participating in the county's Medicaid HMO, the Santa Clara
Family Health Plan. The HMO administers the plan, processes
applications from families and pays medical claims. In addition,
the program provides vision and dental coverage.
Parents pay small premiums (no more than
$18 a month) and co-payments on a sliding scale. Fees are
waived for those who can't afford them.
The Healthy Kids initiative was developed
by a coalition of community groups, county agencies and the
local Medicaid health plan to improve the health and well-being
of low-income children in Santa Clara County.
Drawback: Waiting list
The program is a huge help among the big migrant population
here because Medicaid covers only U.S. citizens. About 80
percent of the children in Healthy Kids are undocumented.
Healthy Kids is financed by state tobacco-tax
money, the city of San Jose, the county's share of the tobacco
lawsuit settlement and contributions from private foundations.
It costs about $14.5 million a year.
The only problem with Healthy Kids is that
it's been too successful. So many parents have sought health
insurance for their children that the program had to start
a waiting list last year. Today, about 1,000 children are
on the list, but because of turnover, kids are usually on
the wait list no more than six months.
Santa Clara County's program is being copied by several counties
in California, including San Francisco, San Mateo and Alameda
counties. In San Mateo, home to Stanford University, income
eligibility goes up to four times the poverty rate, so a family
of four earning $72,500 can still qualify for the subsidized
coverage.
Craig Walsh, a former marketing executive
for the San Francisco 49ers who is the executive director
of Santa Clara's Healthy Kids program, said one of the keys
to its success is the simple message to parents.
"We could tell them, just come
in and we will be able to sign up your child for coverage,"
Walsh said.
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