Universal health goal fades in California

Many children may lose coverage

Arnold Schwarzenegger seeks coverage for all children.

SACRAMENTO, Calif. - California's promising strides toward extending medical coverage to all its children, a longtime goal of Governor Arnold Schwarzenegger and one advocates believed was in reach by decade's end, has stalled - and thousands of children are in danger of losing insurance.

The trend is likely to further destabilize California's already shaky healthcare system. Studies have found that children without insurance are less likely to go to the doctor for routine visits that allow early diagnosis and treatment for diabetes, obesity, and other increasingly common ailments.

Uninsured children are more likely to end up in the hospital or in the state's clogged emergency rooms, where much of the cost of their care is passed along to insured people.

Between 2001 and 2005, the number of Californians younger than 19 who were uninsured at any given time decreased 25 percent to about 763,000, according to the University of California, Los Angeles, Center for Health Policy Research.

Most of the drop came through aggressive enrollment efforts in state and private healthcare programs and despite the erosion of employer-based insurance, which was leaving more adults without coverage.

But legislative budget negotiators this year have decided to increase premiums to the state's Healthy Families program, which pays for medical care for more than 850,000 children of low-income workers who are above the federal poverty line.

The state estimates that the parents of 19,000 children will end up dropping out of the program by next July because of the $2 or $3 monthly increases. A family with three or more children, earning between two and 2 1/2 times the federal poverty level of $24,800 a year, would see their monthly premium rise to $51.

Lawmakers also have decided to require the parents of 3.4 million Californians who are below the federal poverty line to renew their Medi-Cal health coverage every six months. The Schwarzenegger administration expects that rule will pare Medi-Cal rolls by about 196,000 children over the next two years.

State officials say some of those families would leave the program anyway because they moved or found jobs, but advocates believe many who are entitled to the program will fail to file the paperwork and will fall off the rolls.

The changes to subsidized or free health programs come as private health initiatives that pay for the care of children are running out of money, causing them to limit the number they cover.

Altogether, "thousands of California children are likely to lose health insurance coverage they now have," said E. Richard Brown, the director of UCLA's research center. The privately run initiatives exist in 30 counties, arranging medical care for children who either are not legal residents or whose families earn slightly more than the threshold for public programs. Enrollment in the initiatives has dropped by 8,000 in the last two years.

During the 2003 recall campaign against Governor Gray Davis, Schwarzenegger said he wanted all children to have medical coverage. Enrollment in the state's children's programs grew steadily during his early tenure. Then, shortly after his 2006 reelection, Schwarzenegger unveiled a proposal to cover all children and most adults. But the California Senate in January rejected a $14.9 billion deal between Schwarzenegger and Assembly Democrats.