Sacramento Bee
November 16, 2005

Children's insurance moves to fore again

Advocates prepare ballot measure as lawmakers mull legislation.

By Clea Benson
Bee Capitol Bureau

Last year, advocates said they wanted to make 2005 the year for ensuring that all California children have health insurance.

Now they're hoping it will happen next year. About 8 percent of the 10.5 million Californians under 18 - nearly 900,000 - don't have health coverage. About half are eligible for existing public programs but aren't enrolled.

Though Gov. Arnold Schwarzenegger has pledged to expand coverage for children, in October he vetoed a bill to expand enrollment in existing public health-insurance programs, saying it was financially unworkable. Other bills have stalled in the Legislature.

But with the special election over and a renewed emphasis on bipartisan cooperation, advocates say momentum is building on the issue, a popular one with voters, according to polls.

A coalition of children's groups is preparing to circulate petitions for an initiative to fund children's insurance with an additional $1.50-per-pack tobacco tax. If the measure qualifies, it could appear on the November ballot. And lawmakers are dusting off their bills and preparing for another round of debate.

"The momentum is clear," said Peter Long, senior program officer at the California Endowment, a nonprofit foundation working to expand health coverage. "After (the election), people came out and were talking about children's coverage as one of the areas where Democrats and Republicans agree."

The solutions could take many forms in addition to the expanded use of public programs. One proposal, unveiled Tuesday by the nonprofit New America Foundation, would require parents to insure their children, with tough penalties for noncompliance and tax credits for private coverage.

Assembly Bill 1670, written by Assemblyman Keith Richman, R-Northridge, and Assemblyman Joe Nation, D-San Rafael, would provide tax credits to employers for private coverage and implement tax penalties for parents who didn't insure their children or themselves.

During the Schwarzenegger administration, the number of children insured through Medi-Cal and by Healthy Families, a public program for children of the working poor, has increased by about 100,000. The Republican governor approved an additional $162 million in this year's budget to cover additional children and pay outreach workers to sign them up.

Though there are also millions of adults in California and the rest of the United States without health insurance, policymakers have more readily embraced the idea of providing government-funded health care for children. About half of California's children are already insured through Medi-Cal and Healthy Families.

At a panel on health insurance convened Tuesday by the New American Foundation, the governor's secretary of Health and Human Services, Kim Belshé, said Schwarzenegger was committed to working next year on some form of health insurance expansion for children. But she cautioned that the solution would be dictated by financial concerns.

"There's no question we are still grappling with some difficult budget decisions going forward," she said. "It is clear that more can and will be done in 2006."

Belshé also suggested that lawmakers, rather than acting themselves, might want to let voters decide if they want to pass a tobacco tax to pay for more children's insurance.

The potential initiative being pushed by child advocacy groups "calls into question the relevance of seeking legislative solutions on this important issue in 2006," she said.

Assemblywoman Wilma Chan, D-Alameda, author of the bill the governor vetoed, AB 772, said she wants to try to work things out legislatively.

"I'm willing to work with (the governor)," said Chan, whose bill would cost the state an additional $418 million, according to a study by the Lewin Group. "All these proposals have costs. ... If he's willing to work with us on the policy as well as on the costs, there's no need for the initiative."