Stockton Record
December 1, 2006

State exploring kids' health care
Plan would cost $380 million, faces Republican challenges

By Hank Shaw
Capitol Bureau Chief

SACRAMENTO - Gov. Arnold Schwarzenegger and the Democrats who control the Legislature are crafting plans to reduce the number of Californians forced to use emergency rooms as their primary doctor's office.

Ideas range from a Canadian-style, government-run system to a universal health insurance mandate a la Massachusetts to smaller ideas to lower the soaring cost of health care. Chief among those proposals is one to cover every uninsured child in California.

Children's advocates have been seeking this for years, and Schwarzenegger has said since the recall election in 2003 this is a priority for him. He has promised to push expanded access to health care to the forefront of the next legislative session.

Two main roadblocks stand in the way: cost and Schwarzenegger's fellow Republicans. Covering every child in California would require the state to come up with at least $380 million a year - and with the gap between tax revenues and state spending growing larger, paying for new programs could be problematic.

GOP lawmakers also have proved unyielding on earlier expansion plans because they would include children who are in California illegally. About 10 percent of the estimated 700,000 uninsured California children are illegal immigrants, and Republicans have vowed to block state spending on them.

The argument is that doing so provides a powerful incentive for foreign families to bring chronically ill - and expensive to treat - children across the border illegally. Republicans also say universal coverage would siphon scarce funding away from those who have legally earned it.

Advocates note that illegal immigrant children already use taxpayer-funded services through emergency rooms, which is far more expensive than if they could get preventive care.

But any meaningful health care reform will need Republican buy-in because tax and budget legislation requires GOP votes to pass.

Republicans in June blocked Schwarzenegger's attempt to spend $23 million to reduce waiting lists for the 18 counties that provide expanded health care for children, regardless of their status. San Joaquin is one of them.

The waiting list for San Joaquin County's program, called Healthy Kids, is about 380. Healthy Kids covers 2,500 county children ineligible for other subsidized health care services, such as Medi-Cal.

Most are from families who earn too much to qualify for most programs - up to $60,000 for a family of four - but not enough to afford traditional health care. Some are in San Joaquin County illegally, however. David Hurst, marketing director for the program, said he does not know how many are here illegally.

San Joaquin County has between 14,000 and 30,000 uninsured children, Hurst said. The wide range shows how tough it can be to track the uninsured.

Health care advocates such as Stockton's LaCresia Hawkins say they hope Republicans can be convinced to cover all California children. There appears to be widespread support for it among state voters.

Hawkins cited a recent poll sponsored by the United Way that shows 81 percent of likely voters, including two-thirds of Republicans, think children should get health insurance regardless of immigration status.

"I think sometimes you really have to put a face on this and not think about just the dollars," Hawkins said. "I think if they really got out and realized that the majority of their constituents want this, it'd happen."

State Sen. Deborah Ortiz, D-Sacramento, said she thinks the political environment will be different in 2007 and that the bipartisanship begun at the end of the last legislative session will continue. "Voters don't want to see a lot of division," said Ortiz, who is officially termed-out today.

Republicans are in Orange County this week at their annual policy retreat. Morgan Crinklaw, a spokesman for Assembly Minority Leader Mike Villines of Clovis, said the GOP is working on its own plan to increase health care coverage for children.

No detailed policy proposal has emerged yet to tackle the issue, although several are expected shortly after the new year. Schwarzenegger is expected to make children's health care a centerpiece of his State of the State address Jan. 9.