Children could lose access to low-cost health insurance

by Lesley Politi on November 17, 2008

Children could lose access to low-cost health insurance

| Saturday, Nov 15 2008 12:00 PM

Last Updated: Friday, Nov 14 2008 6:53 PM

A children’s health insurance program in which about 900 Kern County children enroll each month may stop taking on more kids because of state budget woes.

Local health officials say the result of capping Healthy Families Program enrollment would be sicker children and therefore increased costs for taxpayers in the end.

“The community pays for it one way or another,” said Jan Hefner, director of the Children’s Health Initiative of Kern County, a community partnership that seeks to expand children’s access to comprehensive health insurance. “We understand there’s a budget crisis but (the state) cutting programs means we’re going to pay for it on the back end.”

The problem is a $17.2 million budget shortfall this year in Healthy Families, which provides low-cost health, dental and vision coverage to uninsured children of working families.

Those are families that earn too much to qualify for no-cost Medi-Cal but not enough to afford private plans. Families pay $4 to $15 monthly premiums per child with a maximum of $45 per family. The state and federal government fund it.

A study showed most of Kern’s uninsured kids are eligible for some type of government-subsidized insurance such as Healthy Families but for some reason aren’t enrolled. So there have been stepped-up, communitywide efforts in recent years to sign them up.

The Managed Risk Medical Insurance Board, which runs Healthy Families, estimates the cap could result in 160,000 California children being waitlisted within six months.

The board is scheduled to meet on the issue this month and next month and is looking at implementing the cap Dec. 18.

Its options for dealing with the shortfall are limited, Lesley Cummings, executive director of the Managed Risk Medical Insurance Board said in a Nov. 7 memo to board members. Not capping enrollment would force “more catastrophic actions later,” like cutting coverage a child already has.

“We are well aware that establishing a waiting list is antithetical to the Board’s mission and desires,” she wrote. “But it is consistent with the board’s obligation.”

It’s particularly worrisome because there’s a trend of workers dropping their families from insurance policies to save money and hoping to enroll them in government-subsidized coverage, said Cristy Cortez-Sackrider, director of public affairs for Kaiser Permanente in Bakersfield.

There are 3,221 Kern children enrolled in Healthy Families through Kaiser.

“It’s kind of a perfect storm,” Cortez-Sackrider said. “At a time when people are losing their private insurance, there are going to be cuts in what the state can do to help.”

From November 2007 to October 2008, 10,543 Kern County children were newly enrolled in Healthy Families, Hefner said. The total enrolled from Kern stood at nearly 26,000 last month, 3 percent of the state caseload.

If qualified children are denied Healthy Families coverage, they are going to miss out on preventative care, get sicker and end up in emergency rooms more often — burdening taxpayers even more, Hefner predicted.

Kern Family Health Care, through which more than 13,000 children are enrolled in Healthy Families locally, is encouraging eligible people to enroll before the cap takes effect, said Louis Iturriria, manager of marketing and public affairs.

The most recent study of its kind, by the UCLA Center for Health Policy Research, found in 2005 there were 31,000 uninsured children in Kern County, according to Hefner. She said 27,000 of those qualified for public insurance programs.

Updated numbers are due out in about three months, she said.


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