Friday, June 5, 1998
Healthy Families fall short on estimates
HEALTH: Fewer children are covered by insurance program than
projected
By Kathryn Combs
Daily Bruin Staff
A recent finding of the UCLA Center for Health Policy Research
revealed that Healthy Families, a recently adopted state-sponsored
insurance program, will not provide health insurance for as many of
California’s uninsured children as was estimated earlier this
year.
Original estimates predicted the Healthy Families program, an
insurance plan adopted last October, would provide health coverage
for 562,000 children from low-income families, approximately
one-third of California’s 1.6 million uninsured children.
However, Steve Wallace, associate director of public programs at
the center, said Healthy Families covers only 400,000 of the
uninsured children not covered by other insurance programs such as
Medi-cal.
"If you look at all the uninsured kids in California that could
be covered … that leaves a little over 800,000 kids that could be
helped," Wallace said.
"Healthy Families has been covering about half, and the other
half are left with nothing and will still be uninsured," he
added.
"Obviously there are still some very large holes to fill in our
health care safety net," said Richard Figueroa, principal
consultant for the Senate insurance committee.
The Healthy Families Program is designed to provide health
insurance for low-income families by subsidizing private firms to
provide care.
This program also encourages the families of uninsured children
to take advantage of employer-sponsored coverage if available.
According to researchers, new estimates take in to account
tighter eligibility requirements and eliminate differences between
how the Census Bureau calculates the poverty level and how public
benefit programs calculate it.
"If you go back to the original way Healthy Families was
designed, you would increase the eligibility by 50,000," Wallace
said.
According to Wallace, shortly after the program was accepted by
the California legislature, Republican legislators argued the
program covered too many of the uninsured children.
Since, changes in requirements have caused the number of
eligible children to dwindle.
Healthy Families makes low-cost insurance available to children
of low-income families, but who do not have an income low enough to
qualify them for other insurance programs. Monthly premiums,
according to Wallace, could go as low as $3 a month, along with a
$5 co-pay for other medical services.
Currently there are three primary eligibility requirements. The
child must not be eligible for Medi-cal services, should have been
without health coverage for at least three months prior and must
come from a family with an income between 100 and 200 percent of
the national poverty level.
Government-sponsored insurance programs often base eligibility
on how much a family makes.
Now, any family at or below an annual income of $16,000 for a
family of four is considered to be living in poverty. Often, these
families are automatically eligible. Income requirements for the
Healthy Families program is above this amount, at what researchers
call "200 percent of the poverty level or higher," or $32,000 a
year.
Suggestions made by researchers include raising the requisite
income level even higher. "If you raise the income limit from 200
to 250 percent of poverty, you get almost 150,000 more children,"
Wallace said.
"There are 8 or 9 other states in this country that are using
income limits of over 200 percent (and) California is by no means
being the most generous," he added.
Figueroa stressed that society will end up paying for those
remaining uninsured.
"The vast majority of these folks are working. They contribute
to society, but for whatever reasons their employer doesn’t offer
coverage and these working families are going without," Figueroa
said.
"It’s a big misnomer in our society that if you are not
purchasing health insurance that society is not paying for it. We
pay for it in higher taxes and higher worker compensation rates,"
he added.
Wallace agreed with Figueroa, adding that those without
insurance seek care less often and this results in overall higher
health care costs.
"Research shows that if you don’t have health insurance you are
more likely to delay getting care. Then it is more costly to treat.
Early treatment makes a difference," Wallace said.
Other concerns plaguing researchers were the inability of
current programs to provide adequate coverage for the children of
undocumented aliens.
"Until there is a larger societal agreement that would recognize
that diseases and colds don’t stop in peoples homes, cars or at the
border, then we all have to worry and take care of each other in
regards to health," Figueroa said. "The public health is clearly
the public health of everybody."