No good options at MRMIB…

Here’s a report by Cynthia Craft, communicatin & policy coordinator at Health Access, from the MRMIB meeting on Thursday:

Disclosing that it likely will have to purge some children from the Healthy Families Program, the Managed Risk Medical Insurance Board, or MRMIB, reported Thursday that the wait list for the program, which froze enrollment July 1, had grown to 33,146 children in just two weeks.

The number was higher than anyone had imagined, and it reflects the bitter irony of cutting health care assistance for kids of low-income, tax-paying, legal residents at a recessionary time when they most need help.

As it now stands, the Healthy Families Program has lost funds that total $533.4 million, including federal matching funds no longer available due to the $194 million cuts made by the Legislature and Gov. Schwarzenegger. The federal government returns $2 of taxpayer funds to Healthy Families for every $1 the state dedicates to the program.

Advocates laid blame at the feet of both the governor and the Legislature for the choices they made in balancing the state budget.

“This is really a dark hour in California, when we are jettisoning children over other interests,” said Steve Barrow of the California Premature Infant Coalition, which strives to reduce the statewide 10% premature birthrate.

The outlook for California’s children in this down economy is likely to get bleaker, still. MRMIB announced it was setting a public meeting date of August 13th to discuss disenrollment, or kicking currently enrolled kids out of the program.

Several health care advocates testifying before MRMIB warned of “dire consequences” if children lost continuity of care, particularly in the case of cancer treatments.

Nearly every one of the two dozen or so who testified spoke of collaborating to find help from outside funders to prop up the Healthy Families program until its financial outlook improves.

Already, the First 5 Commission passed a resolution to help fill the gap for Healthy Families. Kris Perry, executive director of First 5, said it “pledged to provide, with some of the others, some of the funds” for children up to five years old. It was clear that the First 5 Commission was in the position to assist – but only to a point.

Nevertheless, Cliff Allenby, the chair of MRMIB, told Perry, “Needless to say, we appreciate your efforts since we are clearly in a large hole.”

Many held out hope that legislators would be motivated to successfully challenge the cuts upon reconvening after summer recess Aug. 17th.

Healthy Families was established by the federal government for low-income working families to provide health care for their children. State budget cuts made it necessary to establish a wait list for new enrollees July 17, and 14,000 children signed up the first week. Those who are bumped from the program through the anticipated disenrollment would go to the end of the list.

Earlier this year, President Obama announced an expansion of Healthy Families, known in Washington as the SCHIP program, funded by tobacco tax money. The President heralded the move as an important step in his larger goal of reform aimed at extending coverage to the nation’s 42 million uninsured adults. During the previous administration, former President George W. Bush vetoed legislation expanding the program to cover more children.

But California’s troubles, which attendees at the hearing said included a void of “emboldened leadership” on the state level, led to the opposite of what Obama intended. Now, health care coverage is less accessible and less affordable for low-income, working families in California – at a time when several other states managed to cover more children.

Even for families fortunate enough to remain in the much-smaller Healthy Families Program, keeping their children covered will become increasingly difficult financially. MRMIB plans to shift more out-of-pocket costs on to families enrolled in the program. Some of the cost-shifting suggestions read aloud by a staff member Thursday were drastic enough to make audience members audibly gasp.

The proposals, which staff and MRMIB said had yet to be thoroughly analyzed, include:

* Paying for eye exams, but not for glasses.
* Eliminating vision benefits altogether.
* Rescinding a new rate increase to insurers such as Anthem Blue Cross.
* Increasing medical co-pays, such as:
— Physician visits would rise from $5 to $10.
— Name-brand prescriptions would rise from $5 to $10.
— Inpatient hospitalization would rise from $0 to $250.
— Outpatient hospital services would rise from $5 to 20% of the service cost.
— Emergency room services would rise from $5 to $50 unless hospitalized.
— Medical transportation would rise from $0 to 20%.
— Durable medical equipment would rise from $0 to 20%.
— Basic outpatient mental health services would rise from $5 to $10.
— Inpatient alcohol and drug treatment would rise from $0 to $250 per admission.
— Outpatient alcohol and drug treatment would rise from $5 to $10.
— Eye exams, if not eliminated, would go from $5 to $25.
— Subscriber premiums would go from $20 per child to a maximum of $60, in the income range from 150%-200% of the federal poverty level.
— Subscriber premiums would go from $30 per child to a maximum of $90 for families in the range of 200%-250% of the federal poverty level.

As of June 2009, Healthy Families served 920,000 children. In recent months, the program has accepted 29,000 new enrollees monthly.

On Thursday, MRMIB members mostly sat silent while listening to input from the community. Those testifying with concerns about children’s health included Beth Capell, the advocate for Health Access California, who noted that health care costs were the major cause of homelessness for families prior to the launch of Healthy Families.

“We are about to return to those dark days,” Capell said, noting that the governor’s “blue pencil” cuts also obliterated funding for community health clinics.

Capell also pointed out that the number of children at risk of not having coverage in California is greater than the population of 40 states including Massachusetts.

Also testifying in support of children’s health care were representatives from Children Now, the 100% Coalition, the California Teachers Association, the American Academy of Pediatrics, Local Health Plans of California, California Children’s Hospital Association, the Children’s Coalition, PICO, California Primary Care Association, Santa Clara Health Plans and the Community Health Council.

Health Access California promotes quality, affordable health care for all Californians.

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