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North County Times
October 4, 2005
Editorial
Our view: Every child in California should
be covered by health insurance. Bureaucratic barriers that
keep poor families from getting or hanging onto coverage should
come down.
On principle, these truths seem self-evident,
easy for all but the most mean-spirited to agree upon. So
why hasn't Gov. Arnold Schwarzenegger yet signed a Legislature-approved
bill sitting on his desk that would accomplish both of these
worthy goals? As usual, it all comes down to who picks up
the tab.
An admirable coalition of faith-based groups,
children's advocates and health care organizations are backing
what they call the California Healthy Kids Initiative. They
want Schwarzenegger to sign legislation that would increase
access to affordable health insurance for every uninsured
child in the state; make enrolling in and retaining coverage
easier for poor Californians; set up a state panel of experts
to guide the policies; and send Sacramento lawmakers the bill--it
could top $1billion--for this significant expansion of the
social safety net.
This last element is the most problematic,
for the governor and for us. Advocates proposing a big spending
bill should at least have some idea where the money will come
from. Healthy Kids proponents suggested private donations
could pick up much of the slack. It's wishful thinking, and
they know it. We'd be willing to consider a tax increase to
cover the state's poorest kids; so should they. That may make
the political hill that much harder to climb, but at least
the effort would be honest.
Aside from the mystery funds, the Healthy
Kids bill faces a likely veto because it pulls precisely when
Schwarzenegger and the nation's other governors have been
straining to push state-funded health care in the opposite
direction. Despite a 2003 campaign pledge to insure all of
California's kids, the governor lately has been working to
shrink the Medi-Cal rolls and cut red ink at the state's health
insurance program for the poor.
Driven by soaring prescription drug prices
and higher enrollment, Medi-Cal spending has almost doubled
in the past seven years. The $33 billion annual program funded
by the state and federal governments now covers one of every
six Californians. So the governor has pushed for changes that
would require more recipients to pay for parts of their health
care coverage and would kick more people above the federal
income thresholds off the program.
Both ideas have merit. If protecting the poorest
is the program's goals and the state's $7.4 billion deficit
requires thrift, then the state is obliged to narrow Medi-Cal's
scope.
At the same time, society has an abiding interest
in keeping its children healthy. Serious health problems can
be identified early and managed effectively. Educational outcomes
improve when chronic illness is treated. More important, taking
care of our children is just the right thing to do.
Whether he vetoes the bill or not, Schwarzenegger
would be wise to embrace many of its proposals.
Most promising are a series of administrative
changes that would streamline the application process for
getting children enrolled in health care coverage. One, for
instance, would stop making applicants provide redundant evidence
of incomes, as long as they qualify for other federal entitlement
programs, like food stamps and the school lunch program, that
have the same qualification thresholds.
As one advocate put it, how easy would middle-class
folks find it if they had to stand in line to reapply for
employer-sponsored health care coverage four times a year.
If forced to rely on North County's insufficient public transportation,
the hurdle would seem that much higher.
This kind of administrative change could make
a big difference in making low-cost health care that's available
also accessible to families already struggling to make ends
meet. If the reform-minded governor is still interested in
"blowing up the boxes" of the state's bureaucracy,
he would do well to start here.
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