CALIFORNIA: CRITICS QUESTION KIDDIECARE APPROACH

      While a broad range of children's advocacy groups and
 providers are backing Gov. Pete Wilson's (R) Kiddiecare program,
 Healthy Families, the "unanimous approval crumbles ... when talk
 turns to the details," the Los Angeles Times reports.  With
 enrollment set to begin July 1, "analysts question whether
 Healthy Families will enroll enough children -- and keep them
 enrolled -- to fulfill its promise."  Critics also note that
 "even when fully implemented," California's Kiddiecare initiative
 will still leave many children uninsured in the state. 
      COPAYMENT CONCERNS
      The Times reports that critics are voicing concern that
 Healthy Families' sliding-scale monthly premiums and physician
 copayments will "discourage enrollment among the very folks who
 need" the coverage most.  California's program will require a
 monthly premium of $4 to $27, "depending on family size and
 income," and "[m]ost doctor visits will require a $5 copayment." 
 According to critics, the "problem ... is that families already
 stressed to the max to cover rent, bills and groceries may be
 afraid to sign up for yet another obligation.  Or they may
 enroll, only to have trouble producing the cash when the premium
 comes due or a copayment is required."  The Times notes that
 Wilson's Kiddiecare plan requires "children to be bumped from the
 insurance rolls for six months if their parents fail to pay two
 premiums in a row," a policy driven by Wilson's insistence "that
 he does not want Healthy Families to be viewed as a new
 entitlement."  Child health advocates, however, "worry that the
 provision may unfairly penalize children whose parents hit a few
 months of tough times."  Children NOW policy director Amy
 Dominguez-Arms said, "Perhaps (officials) should suspend the
 insurance until they clarify why the parents didn't pay the
 premium, but a six-month (ouster) seems particularly onerous." 
 The Times also notes that making premium payments may pose a
 logistical burden for parents since the program "has no plans to
 open offices for walk-in payment."  Many low-income parents,
 therefore, "will need to get money orders or cashier's checks for
 the premiums" because they lack credit cards or checking
 accounts.
      LEFT BEHIND
      Though Healthy Families promises to extend coverage to
 580,000 uninsured children, "more than a million Californian
 young people will be left behind" (Simon, 12/8).  Yesterday's Los
 Angeles Times reports that Healthy Families makes no provision
 for the "half a million kids whose parents fall in just the wrong
 income bracket:  too rich for Healthy Families, too poor for
 private coverage."  The Times also reports that children in rural
 areas face special access problems.  "The program requires that
 free follow-up treatment be conducted only by authorized
 pediatric specialists."  But because most of these specialists
 "work in big cities ... kids from rural outposts have to travel
 for hours just to get to an appointment" (Simon, 12/7).  Today's
 Los Angeles Times profiles Pasadena's comprehensive approach to
 providing health care to uninsured children (Simon, 12/8).