San Jose Moves Toward Universal Coverage for Children

Officials in San Jose unanimously agreed yesterday to contribute about $3 million of the city's share of the national tobacco settlement to a plan to provide health coverage for all uninsured children in Santa Clara County. According to the AP/Los Angeles Times, the agreement was a "key step" for the Santa Clara County Children's Health Initiative, which received approval last week and is expected to take effect in February. In addition to San Jose's $3 million, the Children's Health Initiative will receive $3 million from Santa Clara County, $2 million from tobacco taxes and $1 million from a county HMO. Children from county families earning up to three times the federal poverty level will be eligible for the program, which will cost an estimated $14 million annually. Earlier this year, city officials in San Jose, the third-largest city on the West Coast, considered but failed to pass a separate, though similar, plan to cover the city's more than 35,000 uninsured children (AP/Los Angeles Times, 12/13).

Following Santa Clara County's lead, the San Francisco Department of Public Health last month issued a report calling for "the creation of a voluntary insurance purchasing pool" similar to Healthy Families. The report found that the city could provide health insurance coverage to its 12,000 uninsured children for between $8.5 million and $12.5 million annually. Under such a plan, the city could offer "comprehensive health care" to each child for a monthly premium of $4 to $9, the San Francisco Examiner reports. "Quite clearly, from a financial and operational point of view, (insuring all the city's children) is quite feasible," Dr. Sandra Hernandez, CEO of the San Francisco Foundation, said. But noting that past attempts at covering the city's uninsured, including a 1998 voter-passed measure to create a voluntary purchasing pool, have "lingered in planning purgatory," the Examiner reports that city health providers and advocates remain concerned about the program's costs, as well as its ability to provide preventive care and to attract enrollees. "You could build hugely affordable insurance programs, but if nobody knows about them, they're not much good to anybody," Hernandez said. Despite these fears, the Department of Public Health, the city Board of Supervisors and the mayor plan to conduct "preliminary meetings in an effort to hammer out a plan by spring 2002," the Examiner reports. Supervisor Mark Leno said, "If the political will is there, we can make this happen. We have to decide that this is a priority" (Mezin, San Francisco Examiner, 12/11).