Fragmented system of coverage vulnerable to budget
Budget Writers Nix Children’s Coverage Expansion
Health Access Alert
June 26, 2006
Legislative leadership and Governor Arnold Schwarzenegger, announced earlier today that they had come to a deal on a state budget. Eager to pass a budget on time this year, they gave up on the fight to expand children’s coverage, one of the sticking points with Republican legislators. Since a budget requires a two-thirds vote, Republican legislators were able to hold up the budget on this issue.
Republicans from both houses had been fuming over $23 million, which had been added by Gov. Arnold Schwarzenegger in his May Revise, to cover about 24,000 children who were awaiting coverage through their local county “Healthy Kids” initiatives. This money is no longer in the budget.
Last week, Republicans had succeeded in getting Democrats to abandon a plan that would have expanded Healthy Families (SCHIP) to all children living in families with incomes below 300 percent FPL ($60,000 for a family of four) beginning in 2008. Also opposed by Governor Schwarzenegger, that plan was slated to cost $1.8 million this year and expand over the next few years.
Both efforts included covering all children, including undocumented children, which make up around 12% of the uninsured children in the state.
Kids’ health hooks voters
By Soraya Sarhaddi Nelson
The Orange County Register
June 25, 2006
The two leading gubernatorial candidates say ensuring that basic health care is available to all of the state’s children will be a top priority for them if they’re in the Governor’s Office next year. The issue is important enough to Gov. Arnold Schwarzenegger that he parted company with fellow Republicans in his proposed budget this year, earmarking $23 million to provide coverage for youngsters in 18 counties who don’t qualify for programs like Medi-Cal or Healthy Families (SCHIP) because they aren’t poor enough or are here illegally.
“As you have heard me say many times, we should not politicize the children and drag them into this,” Schwarzenegger told reporters in mid-June. “Children need to get all the attention, if they are here legally or illegally.”
http://www.ocregister.com/ocregister/news/state/stateelections/article_1192707.php
Comment:
By Don McCanne, M.D.
There is almost universal support for providing all children with health care coverage. Although employer-sponsored coverage has continued to decline, efforts to cover children have offset much of this decline, slowing the rate at which the numbers of uninsured are increasing.
Instead of a universal program of health care coverage, we depend on a fragmented system of providing coverage. Special efforts have been made to cover low-income children though Medicaid, SCHIP (Healthy Families in California), and county programs such as California’s Healthy Kids. Theoretically, all low-income children should be covered through these programs. But what is the reality?
Because of greater state revenues than anticipated, in his May Revise of the budget Gov. Schwarzenegger was able to include funding for the county Healthy Kids program. These funds were not to expand eligibility, but rather they were to fund care for children that were already qualified for this program but were excluded merely for lack of budgeted funds. But in the legislative budget battles, these funds were once again cut, leaving 24,000 children on the waiting list (eligible but unfunded).
SCHIP (State Children’s Health Insurance Program) has been the most successful program of the past decade in expanding coverage for children. Many support its expansion to include all uninsured children. Yet partisanship has prevented a modest expansion of the program in California that would have been accomplished by setting the threshold for eligibility at 300 percent of the federal poverty level.
As long as we have a fragmented system of providing health care coverage, the political debates will center not simply over how much we can “afford” to budget for health care, but also about which citizens we will exclude from any coverage whatsoever.
(I used “citizens” deliberately to separate immigration issues from health insurance issues. Fragmented systems of funding health care result in profound inequities in coverage and access. The fact that 12 percent of uninsured children in California are also undocumented does not change that fundamental premise. We can agree on covering the other 88 percent of uninsured children, and then many of us can continue the battle to see that every person living in the United States receives affordable health care regardless of what documents they possess.)