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Cutting Children’s Health Coverage Will Only Make California’s Budget Situation Worse

By Judy Darnell
State Advocacy Director
United Ways of California
When the May Revise is released, there is sure to be some bad budget news for everyone. But, even in tough budget times, the Legislature and Governor must set priorities and a top priority must be children’s health. Our leaders should work to ensure that this year’s budget decisions do not result in more children losing health coverage because it not only hurts kids, but will also make our state’s bottom line even worse.
While all the details of the May Revise are not yet known, current budget proposals put the health of more than 500,000 California children at risk and would increase the ranks of uninsured children by 60%. Two flawed policy proposals are responsible for these troublesome numbers.
First, current budget proposals would require families to fill out burdensome paperwork four times a year to retain their eligibility for Medi-Cal, rather than annually as is the case today. This unnecessary requirement would create a paperwork morass that is far cry from the annual reporting requirements of private health plans. These are eligible kids – the only reason for the Quarterly Status Reporting (QSRs) is to disenroll children from their health insurance. In fact, it is estimated that these stringent requirements would result in 471,500 eligible children being dropped from their health insurance simply because parents wouldn’t be able to keep up with the paperwork.
We could learn a lesson on unnecessary reporting from the State of Washington, who chose to address their 2002 budget crisis by instituting 6 month reporting requirements for children receiving Medicaid. In just two years, several million dollars were spent on the new administrative requirements. This was due in part because the state had to hire 160 new full-time employees to process the additional paperwork caused by the more stringent requirements. Those costs were for reporting twice a year in a much smaller state than California. Our cost to do quarterly reporting will surely be higher here. Washington ended up rescinding their bi-annual reporting requirements in 2005.
The other worrisome proposal would result in large increases in Healthy Families premiums and co-pays – a 78% increase in Healthy Families premiums and a 50% increase in co-pays, to be exact. Research shows that increases like these will negatively impact enrollment and could hinder a child's ability to receive care when he or she is sick. In a tough economy with the prices of gas and food soaring, families shouldn’t have to worry about their children’s health too. This proposal could disenroll 60,000-70,000 children.
Together, these two proposals would result in half a million children losing their health coverage. Setting any economic arguments aside for a moment, this is unacceptable.
But since this is in the context of the budget, let’s talk about economics for a moment. Providing children with health coverage and preventive care saves money by preventing more serious and costly health problems, actually improving the state’s bottom line. Indeed, every dollar spent on childhood immunizations will save $13 down the road, and providing health coverage to one California child costs approximately $100 a month, while the average emergency room visit is approximately $435.
When you consider that cutting health coverage for kids doesn’t prevent them from getting sick, it is very likely that the current budget proposals will increase hospitalizations for preventable illnesses, costing taxpayers and the state more. Statewide, more than 333,000 preventable child hospitalizations occurred between 2000 and 2005 – at an average cost of $7,000 per hospitalization.
Clearly, cutting cost-effective children’s health programs only makes a difficult budget situation worse by forcing children into more costly types of care. What we should be doing is taking steps to ensure every child has health coverage, not taking actions that will move us in the wrong direction by dropping even more children off the roles.
In the budget debates in the weeks to come, Legislators and the Governor should focus on solving our budget problems in ways that don’t create more problems– they should abandon Quarterly Status Reporting and the huge increases to Healthy Families premiums and co-pays. Taking these steps to maintain health coverage for children who are currently covered is not only good for the health of our kids, but for the health of our economy as well.
United Ways of California is a state association of local United Ways and is a strong advocate of finding expanding health coverage to children in this state. United Ways work closely with local community and business leaders, legislators, congressional members and others to promote this achievable and important goal.
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