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Wednesday, January 03, 2007
Kids Health Care: New Report, Same Stalemate?
By this time next week, we will be inundated with news reports about how to mend the holes in California's health care system. But one part of that debate, in some ways, symbolizes just how hard it might be to find consensus on the issue in 2007.

That part of the debate centers on health insurance for every child living in California. A new report this morning from a national nonpartisan group called Children Now assigns what looks a lukewarm rating (B-) to the current state of health care for kids in the Golden State. The report, using data from a UCLA study published last year, concludes that 7% of all children in the state did not have health insurance in 2005, an improvement from 2001 (10%) but virtually unchanged since 2003.

The authors of the report argue that fully covering children would benefit California's overall economy, from fewer costly ER visits to lower costs for public health services.

But note that the paragraphs above refer only to children who live in California... and not to those who are legal residents. That distinction was the biggest sticking point in the children's health debate of 2006.

Depending on whose estimates you use, there are somewhere around 1 in 10 kids in California who are not legal residents. As a result, they are ineligible for most state-funded health care services. In 2006, a proposal from Governor Schwarzenegger to expand a pilot program in several California counties had to be removed from his budget proposal, because legislative Republicans refused to vote for any new spending that could go toward coverage for illegal immigrants.

And that opposition remains. "I don't think it's changed at all, from our caucus' perspective," said Assembly GOP Leader Mike Villines (R-Clovis) in an interview a couple of weeks ago.

Many legislative Democrats, however, remain determined to push forward with full coverage for all children, regardless of immigration status.

And because children's health care coverage has become entangled in issues technically outside the subject of health care, it's easy to see how the same thing could happen in the broader health care debate. For example, the economic impact to the business community of some sort of employer-mandated health insurance isn't about health care per se... but the issue could easily derail health care negotiations at the Capitol in the coming weeks and months.

With all of this in mind, listen very closely next week-- not only to what the governor says about health care reform in his State of the State speech... but also for what kinds of reactions he gets from legislators and powerful interest groups.