Tough times = 63,000 kids wishing, waiting for health care

Continuing its trajectory of growth, the waiting list for Healthy Families has reached 62,955 California children whose families are seeking affordable health care coverage for their kids.

The list has grown by about 3,000 children per work day since the state’s Managed Risk Medical Insurance Board started taking names instead of enrollees July 17 because of state budget cuts.

The new tally was announced Thursday at a MRMIB meeting, one of a series held to consider cost-cutting options for its insurance programs of last resort for low-income, working Californians unable to afford health care coverage on the open market.

The meeting took a somber tone as MRMIB, its staff and children’s advocates continued with their task of doing the least harm to their programs while following the mandate of Governor Schwarzenegger to “live within our means,” through severe state budget cuts.

For every dollar in state general funds denied to Healthy Families, at least $2 in federal matching funds is lost. Schwarzenegger and the Legislature slashed $194 million from the children’s health care program in the last round of budget cuts.

No one in the MRMIB auditorium on Thursday seemed eager to embrace the brutal consequences of drastic program cutbacks looming on the horizon.

Nonetheless, the staff of MRMIB made several recommendations, mainly embracing the least onerous cutbacks or cost-sharing proposals that require families to pay more out-of-pocket — or lose coverage for certain health care services.
The board was reminded that, although they must ultimately vote to recommend changes, they “are not the deciders.” Only after statutes are approved by the Legislature would any changes get enacted. Among the recommendations the board must ultimately make are:

  • Come October 1st, continuing with plans to disenroll children from Healthy Families, barring a miracle of additional funds being pledged. Already, the First Five Commission has offered up $81.4 million to cover an estimated 200,000 children up to age 5 for a year. On Thursday, it was clear that many people still held out hope that an angel funder will yet surface – whether from the public or private sector.
  • Placing tens of thousands of children – and likely more – on the bulging waiting list during the fiscal year that ends July 1, 2010.
  • Imposing higher co-pays and premium payments on families lucky enough to have their children still covered, for now, by Healthy Families program. Board staff on Thursday recommended that, for emergency room visits, co-pays rise from $5 to $15, a proposed hike that is less severe than those earlier considered. Co-pays for non-preventative health, dental and vision would increase from $5 to $10, and co-pays for brand name prescription drugs would increase from $10 to $15, with generic drugs increasing from $5 to $10. Staff recommended against increasing subscriber premiums, saying the hike was “a bit too much in this economic environment.”
  • Eliminating whole categories, or levels, of health care services for current enrollees. Staff recommended rejecting proposals to eliminate vision, mental health and substance abuse treatment. Dental services would be cut back to a level consistent with what state employees get.
  • Freezing new enrollment in the Access for Mothers and Infants, or AIM, program for pregnant women receiving prenatal care. It turns out that, because fewer women have enrolled in the program, the date to freeze pregnant women out has been delayed from January 1, 2010 to March 1, 2010. And, babies born to women in the program would be guaranteed coverage in Healthy Families for their first year of life.
  • Pulling funding from Rural Health Demonstration Projects underway in a number of counties. So far, seven dental care programs and two health care programs have been cut.

    Several children’s groups urged the board and its staff to approach program cutbacks so that those who most need the health care services get top priority. A letter from the California Children’s Health Initiatives asked the board “find solutions that do the least harm to vulnerable children and those needing care.”
    Krystal Moreno Lee of Children Now told the board, “The clock is ticking. We hope you look at and exhaust every avenue available to avoid disenrolling children from the program.”

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

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