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Posted on Thu, Jan. 04, 2007
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Governor wants health care assured for all children
By Jordan Rau
LOS ANGELES TIMES

SACRAMENTO - Gov. Arnold Schwarzenegger will propose that all Californian children, including those of undocumented immigrants, be guaranteed medical insurance as part of the health-care overhaul he intends to unveil next week, according to officials familiar with the plan.

If enacted by the Legislature, his proposal would affect about 763,000 children who currently lack insurance.

While the administration has not revealed details of how it would pay for such a program, officials estimate that extending insurance to all children could cost the state as much as $400 million a year.

That would be a small piece of Schwarzenegger's stated goal: to ensure medical coverage for all of the 6.5 million Californians who now have none.

Experts say that could cost upward of $10 billion a year. If successful, the governor's effort to cover all children would be a substantial political feat.

Only a handful of other states guarantee coverage for all those younger than 18. Schwarzenegger himself vetoed a measure to cover all children in 2005, complaining that lawmakers offered no way to pay for it.

California's Republican legislators, who blocked a more modest effort to extend health care coverage last year, are sure to rebel against a plan that includes children of illegal immigrants.

Schwarzenegger is scheduled to announce his full health plan Monday. His office is still finalizing many parts of that package, but aides have made clear that it will be an ambitious effort to restrain health care costs and reduce the state's uninsured population.

All sectors of the health care industry, including hospitals, insurers, doctors, patients, businesses and government, would pay some of the costs under Schwarzenegger's plan.

People familiar with the proposal say it includes new requirements for businesses to cover employees, though the details were unclear. The more cost employers and workers shouldered, the less the state would have to spend.

In addition, a number of measures favored by some aides, such as limiting the profits of insurers, remain undecided.

"There is no final health plan," said Adam Mendelsohn, Schwarzenegger's communications director. "As has been the case from the start, all ideas are on the table and the final touches are being applied. The administration is not confirming the inclusion of any one piece."

But several independent sources said Schwarzenegger has committed to the framework of the children's insurance portion.

Administration officials have privately told people outside government that they intend to guarantee medical coverage for children of families earning up to 300 percent of the poverty level, or $60,000 a year for a family of four.

Those families have 90 percent of the children without insurance, but the cutoff is not yet set in stone.

Schwarzenegger's proposal goes further than one put forward last month by Senate President Pro Tem Don Perata, D-Oakland, which excluded illegal immigrants.

Assembly Speaker Fabian Nunez, D-Los Angeles, incorporated children of undocumented residents into his plan, which was also announced in December.

About 90 percent of California's children already have insurance, either through their parents' coverage or through state Medi-Cal programs that help the impoverished.

For years, advocates have been pressing lawmakers to finish the job, arguing that the electorate would be particularly sympathetic to the plight of children.

"It's the low-hanging fruit of the health-care reform debate," said Dr. Bob Ross, president of the California Endowment, a private foundation in Los Angeles created to push for expanded access to health care.

"Kids are relatively cheaper to cover" than adults, he said. "From a public health standpoint, it's smarter to cover all children regardless of immigration. You just don't want unimmunized kids surfing around in the population."

Such arguments have yet to win the day in Sacramento. Last year, Schwarzenegger backed a budget plan that would have helped fund local children's initiatives.

Republican lawmakers blocked the proposal, because it would have included coverage for children of illegal immigrants.

"We believe Californians do not want to reward illegal behavior," said the Assembly Republican leader, Mike Villines of Clovis. "There are so many here (legally) who are hurting and trying to make ends meet, we've got to focus on them first."