UNINSURED CHILDREN: Remove Barriers to Care
Writing in today's Los Angeles Times, Robert Fellmeth, director of the Children's Advocacy Institute, notes that after more than a year of operation, the state's Healthy Families program has only 110,000 children enrolled, "and the state actually has a net loss of 200,000 fewer children medically covered than it did three years ago," primarily because "for every child enrolled in Healthy Families, there are two who have lost Medi-Cal coverage." He writes that in addition to "fundamental barriers to coverage" such as multiple bureaucracies, fragmented programs and "gratuitously high annual premiums," the "basic problem is that the state bureaucracy reflexively views sick children as potential chiselers trying to get undeserved benefits." He notes that if the state cannot make Healthy Families work, "it will forfeit more than $3 billion in federal funds by 2004-05, the biggest give-back of federal funds in the nation's history."
Fellmeth recommends that the state adopt the Children's Advocacy Institute's California Children's Budget, which would institute "presumptive eligibility" for every child under which the only two questions that would be asked are if the child has insurance and, if not, whether the family's income level qualifies. He asks, "Why should we block the 85% eligible for fear that someone among the 15% may get some antibiotics for an ear infection?" He also recommends that rather than charging a premium to Healthy Family enrollees to prevent "crowd out," a small subsidy be given to employers, "thereby keeping employee costs close to the level of Healthy Families" (Fellmeth, 7/12).