Governor’s Budget Choices Would Dismantle Child Health Programs Despite Chorus of Opposition
By Mike Odeh, Children Now and Michele Stillwell-Parvensky, Children’s Defense Fund-California
Yes, times are tough for California. But tough times don’t justify putting kids at the back of the line, and yet that’s what exactly what Governor Brown’s recently released May Revision budget proposal would do when it comes to children’s health.
We know that children with health insurance get better preventive care, do better in school, and live healthier overall. But health coverage is only half the story; children also need meaningful and timely access to health care services and providers.
That’s why it’s so troubling that the Governor has a proposal that jeopardizes children’s access to health care by eliminating the state’s successful Healthy Families program and transitioning nearly 900,000 kids to Medi-Cal over an aggressive nine-month time period. The Governor has maintained this proposal despite a chorus of opposition from a coalition of more than 40 organizations, including health care providers, children’s advocates, and faith groups.
The threats to children’s health care go even further. The Governor has additionally proposed to reduce the rates paid to Healthy Families plans to equal the rates paid in Medi-Cal, which already has the lowest level of per-child spending in the country. The providers that treat our children everyday should be focused on providing care, not on navigating through the confusion of an ill-timed transition.
Some children and families on Medi-Cal already have trouble finding providers who will treat them due to the program’s low reimbursement rates, and shifting an additional 900,000 children into the Medi-Cal program in such a short amount of time could cause even more challenges for children trying to access needed health care. Especially as the state moves forward with implementation of federal health reform, now is the time to strengthen access to care in Medi-Cal and recruit more providers, not to further strain the system by hastily adding hundreds of thousands of additional children to the program.
The Governor’s most recent budget blueprint includes additional proposals that harm children’s access to care. One proposal, subject to federal approval, would increase co-payments for Medi-Cal enrollees, including children. This proposal includes a $15 co-payment for non-emergency use of an emergency room, even if an emergency room is the only place a family can access care. Health services research has shown that even relatively small co-payments can decrease access to and use of needed services.
Another new proposal would divert $40 million from the First 5 Commission to Medi-Cal, thereby impacting First 5’s ability to provide local health care and other services for young children. The Governor has also proposed to restrict eligibility for the California Children’s Services’ Medical Therapy Program, which will prevent 4,700 special needs children from receiving physical and occupational therapy services critical to their development.
We think there’s a better way to protect children’s health in the state budget. A broad coalition of health leaders, pediatricians, other health care providers, and community and faith organizations have supported a reasonable alternative to the Governor’s proposal. Specifically, we support a transition of only those Healthy Families children with family income up to 133% of the federal poverty level – also known as “bright-line” children because their transfer would create a clear eligibility line between the two programs – from Healthy Families into Medi-Cal.
This population of children are the most likely to benefit from Medi-Cal’s advantages and protections, namely no co-pays or premiums. Furthermore, these children are also required, under federal law, to be enrolled in Medi-Cal by January 2014. This alternative would also implement safeguards to ensure that there is adequate access to care, and rigorously evaluate Medi-Cal’s ongoing and future capacity to serve children.
This is a thoughtful, common-sense alternative proposal that was recommended after careful analysis by the Urban Institute and the Legislative Analyst’s Office. The alternative proposal was also adopted by the Assembly Budget Subcommittee on Health and Human Services in April.
Simply put, the Administration’s children’s health proposals would penalize children in a rush to score budget savings. In contrast, there’s a lot of weight behind an alternative plan that puts children’s health first through a manageable transition of “bright-line” children that ensures, strengthens, and evaluates access to care in a smart and responsible way.
Tough budget decisions shouldn’t be made on the backs of children. If children are a top priority, our budget should protect their health programs and their access to the care kids need to grow up healthy and strong.
Mike Odeh is a Senior Health Policy Associate with Children Now, a nonpartisan research and advocacy organization working to raise children's well-being to the top of the policy agenda. Michele Stillwell-Parvensky is a Policy and Communications Associate in the Oakland office of the Children’s Defense Fund, a non-profit child advocacy organization that has worked relentlessly for nearly 40 years to ensure a level playing field for all children.