Cutting Off Kids for Christmas: California Considers Wait Listing Children for Healthy Families Coverage

Every single speaker at the MRMIB Board hearing yesterday urged the board to explore other alternatives, and to delay any freeze in Healthy Families enrollment and impose it if necessary only as the very last resort. Many argued that the harm to the program could be irrevocable because of the gap in health insurance coverage has real health consequences for children.

Also, the confusion surrounding off-and-on-again enrollment in the program does not convey the stability and accessibility of treatment for chronic conditions such as asthma, diabetes, and obesity. One community clinic advocate described how Florida never returned to their previous enrollment level attained before freezing enrollment because of the uncertainty it created for families even after lifting their waiting list requirement.

The most compelling testimony at the Board Meeting by far came from families enrolled in Healthy Families. They spoke about the impact the program had had on the lives of their children and the peace of mind it gave them to have a stable health resource and access to diagnostic tests and specialty care.

Advocates, providers, associations, and families all implored the Board not to take this action at all or at least not prematurely Here is a sampling:

• Cliff Sarkin, representing the Children’s Defense Fund, PICO, and the 100% Campaign, spoke on behalf of California’s children and many children’s organizations. He emphasized the importance of maintaining a strong safety net like Healthy Families during a period of an economic downturn. He urged the Board to explore other scenarios and not to let California become the only state to establish a waiting list.

• David Ford from the California Medical Association argued that the Board should explore other options during the remaining month before they feel they have to make a decision. He predicted that families without health insurance coverage would either go without care until their health status worsened or would go to emergency rooms (either of which are more costly alternatives.)

• Leona Butler representing the Local Health Plans of California urged the Board to explore unconventional funding sources such as the possibility of using First Five funding to cover costs for Healthy Family enrollees up to age 5 to defer some costs. She also said that the Healthy Family providers she represents might even be willing to take a 5% cut in reimbursement to avoid the cap on enrollment.

• Bonnie Ferreira from the Children’s Health Care Initiative also counseled about the negative spillover effect and confusion that the waiting lists would have on this and other public health programs.

• Dr. Richard Penn, representing The Academy of Pediatrics, testified that many families would not seek care without health coverage and we would lose any of the gains we have made in health status by taking advantage of opportunities for preventative care.

• Al Hernandez from Latino Coalition for a Healthy California also emphasized the huge impact this program has for the largest ethnic group of enrollees, Hispanic children.

• From Health Access, I stressed the importance of the higher federal funding match rate for Healthy Families—which should make this the very last program that should be frozen. She also highlighted the efforts in the U.S. Congress to temporarily increase the federal matching share payments to the states and the hopeful signs that there would be a stimulus package that would provide some additional money to fill the state funding gap. These actions at the federal level might make freezing enrollment unnecessary, delay the implementation of a freeze, or cause any cap on enrollment to be in effect for a shorter period of time.

It is anticipated that the board will vote on this at their next board meeting on December 17, 2008 in Sacramento.

ACTION: Please contact your state Assemblymember and state Senator and urge them to support finding money in the state budget to fund Healthy Families, one of the most successful health programs for children in the nation. We cannot think of decision less in keeping with the holidays to freeze enrollment for Healthy Families in December.
For more information, contact the author of this article, Elizabeth Abbott, at eabbott@health-access.org.

Health Access California is a statewide health care consumer advocacy coalition of over 200 groups. This article has also been published on the Health Access Weblog.