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Posted on Fri, Sep. 30, 2005

Child health care bill's fate in governor's hands

By Rebecca Rosen Lum


Victor Jacobo's children had never seen a doctor until his 2-year-old daughter suffered an asthma attack. He rushed her to an emergency room in a neighboring town.

The 29-year-old Pittsburg father, who mans his own carpet cleaning business, cannot afford health insurance. That means no check-ups: visual, medical or dental.

His daughter's visit to the emergency room cost him $1,800. Jacobo did not know his children qualified for the state and federal Healthy Families program, which covers youths ineligible for Medi-Cal.

With as many as 12,000 of Contra Costa County's underage residents uninsured -- as well as 25,000 in Alameda County and 800,000 statewide -- health care advocates are hoping Gov. Arnold Schwarzenegger will sign a bill that provides an ample safety net for children such as Jacobo's.

They are unlikely to get their wish.

California Healthy Kids would substitute a single, streamlined health care plan for Medi-Cal and Healthy Families and encompass children in poverty who do not qualify for either of those plans.

The bill, sponsored by Assemblywoman Wilma Chan, D-Oakland, passed 49-29 in the Assembly and 25-12 in the Senate. Schwarzenegger has until Oct. 9 to sign or veto it.

Schwarzenegger feels this is "not the right bill at the right time," said Nicole Evans Kasabian, a spokeswoman for the state Department of Health and Human Services.

The governor has taken other actions to provide coverage for the state's young, said Evans Kasabian. He did not cut Medi-Cal and he increased funding for Healthy Families by $150 million, adding 125,000 slots to the program.

Chan's bill would qualify children if they meet criteria for school lunch programs, the California Special Supplemental Nutrition Program for Women, Infants and Children or the food stamp program. Parents could fill out a single application for subsidized hot lunches and health care.

The law would be phased in over three years, beginning in 2006. The cost: $10 million in the first year and $300 million a year beginning in 2008.

No states have passed universal coverage for all needy children, said Jody Ruskamp-Hatz, policy specialist with the National Conference of State Legislatures. Several have a single office to oversee Medicaid and state programs.

"When we piecemeal legislation, it's always more expensive, more complicated, and presents more barriers to families," said Paula Heinz, program manager for Contra Costa County's Child Health and Disability Prevention Program. "If we eliminated the (separate) bureaucracies, we could afford to insure many more children."

Undocumented workers and those whose incomes are higher than the poverty level but too low to pay for insurance are not eligible for Medi-Cal or Healthy Families. For many of them, hospital emergency rooms substitute for preventive care.

"Most of our congregation -- I'd say 90 percent -- would not qualify (for either)," said Carolyn Krantz, a member of the 25-congregation Contra Costa Interfaith Supporting Community Organization.

The cost of providing unreimbursed emergency care has driven health care providers out of the field, including Tenet. The company pulled up stakes in West Contra Costa two years ago, citing 10,000 emergency room visits a year.

Two recent reports by the Census Bureau show more families are living in poverty, statewide and across the nation.

Many who would benefit from the bill are the children of undocumented workers, but that's not why the governor cooled to it, Evans Kasabian said.

"It actually had to do with the administrative structure," she said.

Republican leaders say the governor is right to limit services to non-citizens.

"There are two primary arguments opponents of services to illegal immigrants make," said GOP consultant Dan Schnur. "The first is about cost and the second is about fairness."