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More Children Have Health Insurance – But with Catch

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Report finds more children are being pushed into government programs

By Chris Levister –

Studies have shown one in four Californians lacks health insurance. In fact a March 2011 study released by the UCLA Center for Health Policy Research found the number of patients using "safety-net" health care in San Bernardino County soared during the past two years, at the same time other studies found more than 2 million Californians lost their health insurance in 2008 and 2010.

But there’s a glimmer of good news for California’s children. A new report released Tuesday by researchers at Georgetown University found more children have obtained health insurance over the past few years despite a sharp increase in the number of kids living in poverty. But there’s a catch.

While California has made significant progress in reducing the number of uninsured children from 2008 to 2010 and continues to cover children at a rate above the national average, the report found as employers drop dependent coverage, more California children are being pushed into public programs, although funding cuts and long waiting lists are slowing enrollment.

California now has a higher proportion of uninsured children enrolled in public programs (32 percent) than the national average (31 percent), but proportionally less in employer-based plans.

"Over the last 10 years, states have made advances in expanding eligibility to more moderate-income families and have also simplified application and renewal processes to increase children's enrollment and retention in the programs," the report found. The study was conducted by the Georgetown Health Policy Institute's Center for Children and Families.

According to the report, the number of uninsured children dropped from 6.9 million in 2008 to 5.9 million in 2010 -- with 34 states registering a significant decrease.

The study showed Massachusetts has the lowest rate for uninsured children, while Nevada has the highest.

The authors attribute the improvements in those years to expansions in the Medi-Cal, Healthy Families, Healthy Kids and California Kids programs, as well as to eligibility and enrollment outreach efforts. Still slightly more than 12 percent of California children are uninsured, higher than the national average of 11.3 percent. That high rate exists despite the fact that in 2007 nearly 80 percent of uninsured children were eligible for public coverage.

The Medi-Cal and Healthy Families programs cover about onequarter to one-third of California children in all age groups, the report notes.

“This report highlights a rare piece of good news at a challenging time for children - poverty has gone up, but more kids are insured,” said Joan Alker, Co-executive Director of the Georgetown Center for Children and Families.

“State leaders, with strong federal support through Medicaid and CHIP, have provided some much needed peace of mind to many families struggling to meet their children’s health care needs during perilous economic times. These gains are fragile and could quickly be reversed if state or federal support erodes.”

U.S. Census data show Southern California districts in San Bernardino, Riverside and Imperial Counties had the highest percentages of uninsured children. Districts in the Bay Area counties of San Francisco, San Mateo and Santa Clara had the lowest percentages and numbers of uninsured children.

California Senate District 32, encompassing part of the Inland Empire, all of Pomona in Los Angeles County and also parts of San Bernardino, including all of Bloomington, Fontana, Montclair, Muscoy, Ontario, and Rialto and parts of Colton and San Bernardino, had the highest percentage of uninsured children (9.7%) and the highest overall number of uninsured children: 34,000.

California Assembly District 80, spanning all of Imperial County and portions of Riverside County, had the highest percentage of uninsured children (11.5%) and the highest overall number of uninsured children: 20,000.

President Barack Obama signed an extension of CHIP (Children's Health Insurance Program), and provided $87 billion to help states pay for Medicaid in the 2009 economic stimulus, and experts say a bipartisan national commitment aimed at covering children has given states new tools and incentives to follow through. For example, some states once required face-to-face interviews; now many states have online applications.

The Affordable Care Act should also help preserve these gains going forward, said Alker.

"We will move to a culture of coverage. The presumption is everyone has insurance," she said. "Families will feel there's an option out there for them."

The Supreme Court has agreed to hear arguments challenging the constitutionality of the historic health care overhaul next year.

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