Ambar Garcia, who lives just north of downtown Los Angeles, said she’s thankful her two daughters have health coverage through California’s version of Medicaid, the government program for low-income people.
That’s one less bill to worry about. But Garcia, a 30-year-old receptionist at a dental office, said she still has trouble paying the rest.
Nearly all of her monthly income goes to her rent, so she relies on her mom to help with child care, and the federal Women, Infants, and Children program to help with food. “I have to work a lot to be able to put food on the table and a roof over their heads,” she said.
Garcia is like many parents in California, whose children have among the best access to health insurance in the country but also rank near the bottom in terms of economic well-being. Those are the findings of KIDS COUNT, an annual report released Tuesday that looks at health indicators such as medical coverage, death rates and teen birth rates, as well as financial circumstances like poverty rates and parental employment.
Overall, California ranked near the top in the nation on children’s health but near the bottom for their economic well-being, according to the report, issued by the Annie E. Casey Foundation.
Many of the 9 million children in California live in families that are one major expense away from being thrown into a financial “tail spin,” said Laura Speer, associate director of policy reform and advocacy for the foundation.
“The economic well-being of families in [California] is really lagging,” she said. “And that has lots of implications for kids.”
Nationwide, families have finally started recovering from the recession and have achieved greater economic stability, according to the report. Ninety-five percent of all children in the U.S. have health coverage — a historic high. But about 14 percent live in high-poverty neighborhoods, according to the study.
In California, the percentage of uninsured children dropped from 9 percent to 3 percent between 2010 and 2015 — the largest decline in the nation during that time. The drop is largely attributable to California’s early and enthusiastic embrace of the Affordable Care Act, which brought health coverage to previously uninsured children through the expansion of the state’s Medicaid program, known as Medi-Cal, and the insurance marketplace, Covered California. More than half of the state’s children are now on Medi-Cal. That includes children who are undocumented immigrants, for whom the state began offering full health benefits through Medi-Cal in 2016.
Despite these gains, more than 1.9 million California children — about 21 percent — live in poverty, and 45 percent live in homes where parents spend nearly a third of their income on housing.
“It’s alarming that in the state where we have a strong economy … we rank 46th in kids’ economic well-being,” said Ted Lempert, president of Children Now, an advocacy and policy organization based in California. “Our families are not benefiting from this strong economy.”
The rankings are not a comprehensive gauge of kids’ health, relying only on some key indicators. Some of the factors associated with poverty, for example, such as poor nutrition and living in high-pollution neighborhoods, are known to have an adverse impact on health. But they were not factored into the study’s health measurement.
Lempert said that in addition to signing kids up for health coverage, the state needs to emphasize other social and financial programs to help families. That could include home nurse visits for new moms and child care subsidies for low-income children.
Alhambra, Calif., resident Bon Oupasene, 38, said she has difficulty providing her children with everything they need. Her three kids get health care through Medi-Cal, she said. But they get no other assistance from government programs.
Oupasene lost her job as a preschool teacher four years ago when the school where she worked shut down. Now the family depends on her husband’s income as a plumber.
She wants to find another teaching job but knows that child care for her 4-year-old would eat up most of her income, so she is waiting until he is in elementary school. In the meantime, Oupasene said, the family tries to stick to a tight budget. It’s not easy, especially with two children in high school.
“Trust me — I struggle a lot,” she said. “But the kids are my priority. They’re my life.”
Despite insurance gains for kids, some key programs in California such as Cal Fresh, which provides food stamps, are underutilized, said Caroline Danielson, senior fellow at the Public Policy Institute of California.
“There are ways in which our social safety net is not moving in sync as well as it should,” Danielson said.
In addition to the high cost of housing, the diversity of the population may also contribute to some of the economic challenges facing children, Danielson said. Many immigrant parents, especially those in the country illegally, have lower wages and less job stability.
According to the report, 32 percent of children in California had parents who lacked secure employment in 2015, compared to 29 percent in U.S. Forty-five percent of children in California lived in households that spent more than 30 percent of pre-tax income on housing, compared to 33 percent nationally.
Also, a higher percentage of California’s children were in families in which the household head lacked a high school diploma, and a higher proportion of the state’s kids lived in high-poverty areas.
This story was produced by Kaiser Health News, an editorially independent program of the Kaiser Family Foundation. The Annie E. Casey Foundation provides funding for some KHN editorial coverage.