100 Percent Campaign Calls for Health Insurance to Be Made Available to Every Child in California by Year 2001.

LOS ANGELES--(BW HealthWire)--Sept. 17, 1998--

Strategic Audit Outlines Specific Steps and Identifies

Funding to Provide Health Insurance to California's

Estimated 1.74 Million Uninsured Children

The 100 Percent Campaign Thursday called for California's government, business and community leaders to take action to provide health insurance to every uninsured child in the state within three years, and issued a "Strategic Audit" that provides a roadmap and identifies funding for getting the job done.

"The fundamental building blocks are in place and the funding is available to provide health coverage to every child in the state," said Wendy Lazarus, director of The Children's Partnership and co-author of the "Strategic Audit." "California can and should move immediately to insure all of its children.

"There is no single magic bullet, but if we work together, this important step for the health of children is within our reach," Lazarus added.

The plan for achieving health coverage for all children in California is outlined in "Reaching 100 Percent of California's Children With Affordable Health Insurance: A Strategic Audit of Activities and Opportunities," a publication of The Children's Partnership developed in cooperation with the Children's Defense Fund and Children Now as part of the 100 Percent Campaign.

The audit, which was introduced Thursday at a forum held by the Universal Health Coverage for California's Children Coalition, provides an up-to-date profile of California's uninsured children, analyzes key building blocks for insuring children, and offers a practical plan for achieving 100 percent coverage of kids.

The audit is based on six months of analysis including interviews with more than 70 health and business leaders across California. Specific recommendations contained in the audit include: 1. Make Medi-Cal and Healthy Families work effectively for the more

than 1 million uninsured kids who are eligible but not currently

enrolled.

Key steps include: the development of a sustained and vigorous outreach campaign in local communities across California to underscore the value of health insurance and to recruit families into the programs; a strong, clear statement from the Immigration and Naturalization Service (INS) allaying immigrant families' fears that using these programs will affect immigration status; and, significant improvements in the existing Healthy Families and Medi-Cal programs to simplify the application form and enrollment process and create a coordinated, seamless children's health-care system. 2. Extend Healthy Families to the roughly 200,000 children in

working families who cannot afford the full cost of insurance

(those with annual incomes of less than $49,350 for a family of

four).

Key activities include: the extension of Healthy Families to children with family incomes above 200 percent of the federal poverty level (FPL) up to 300 percent of FPL; implementation of careful policies to ensure that Healthy Families dollars are used to cover currently uninsured kids and not as a substitute for employer-provided coverage; and, the examination of options for expanding Healthy Families coverage to parents, including the possibility of implementing an employer buy-in for parents. 3. Enable families with higher incomes to buy affordable health

coverage through the Healthy Families purchasing pool or other

community-based and private sector solutions.

The challenge in addressing the situation for families with incomes above roughly $50,000 annually for a family of four (300 percent of the FPL) is how to offer them the chance to buy into affordable coverage while not undercutting the employer market.

Key strategies include: allowing families that have incomes above 300 percent of the FPL to buy into Healthy Families; and, encouraging and expanding private sector strategies to provide and/or market low-cost child products at full price, and provide subsidized coverage. 4. Shore up the safety net for children who do not fit the

traditional insurance model including homeless, migrant and

undocumented kids.

The safety net for California's disproportionately large number of children who are homeless, in the migrant stream or undocumented needs to be preserved and strengthened.

Key steps include: strengthening the programs that currently provide services to these hard-to-reach children, including the Child Health and Disability Prevention Program (CHDP) and Early Access to Primary Care (EAPC); creation of a Safety Net Fund using tobacco settlement funds set to be allocated to counties and cities to provide health-care coverage to safety net kids and their parents; redirection of community-based and private sector resources that provide care to uninsured children now covered under Healthy Families to safety net kids; and referral of families through targeted outreach in immigrant and migrant communities to safety net providers. 5. Conduct a vigorous public education campaign for parents to

underscore the value of getting insurance for their children and

assist them in doing so.

The experience with Medi-Cal and Healthy Families makes clear that offering health insurance to 100 percent of children will not assure that all these children actually get coverage. Additional steps must be taken to educate parents about the value of enrolling in a plan and using its services.

A sustained public education effort with significant reach and "buy-in" is needed to motivate families to avail themselves of the health plans available. The campaign should also help families learn how to obtain coverage. It is vital that it be a multilingual effort and that it target particularly hard-to-reach families including, for example, immigrant communities, teen parents and the unemployed.

The audit also contends that the roughly $2.5 billion in federal funds available for children's health insurance in California, and the $23 billion over 25 years expected from the tobacco lawsuit settlement, provide more than enough funding to provide coverage to every uninsured child in the state.

If all of the estimated 670,000 remaining uninsured children were covered through Healthy Families (which the audit does not recommend but is the easiest way to look at costs) the federal and state tab comes to roughly $600 million.

This amount is in addition to the $485 million per year in federal and state funding officials estimate it will take to cover the 400,000 uninsured children currently eligible for Healthy Families. Equally important, the state must spend its allotment of $2.5 billion by Sept. 30, 2000 (the end of the federal fiscal year), or risk losing the remaining funds to other states.

Even if the state succeeds in fully implementing its current efforts through the Healthy Families program, it will only expend $500 million by the end of this period -- leaving roughly $2 billion to be reallocated to other states.

"While providing health insurance to all California children is possible, we have a limited window of opportunity to draw down available federal funds and get the job done," said Lois Salisbury, president of Children Now. "Clearly we need to accelerate our efforts.

"California taxpayers have paid for their share of federal funding and it would be short-sighted and foolhardy to lose our grant dollars to other states when so many California children lack coverage," Salisbury added.

The audit also provides a context for the issue of uninsured children, examines current strategies for insuring children, and identifies other ideas from across the country. Moreover, the audit identifies additional research needed to develop sound plans for insuring the remainder of children in California.

"The goal of reaching 100 percent of California's kids with health coverage is achievable, affordable and long overdue. What is required now is for the various stakeholders to work together in unprecedented ways toward this common goal," said Deena Lahn, California Health policy director, Children's Defense Fund.

"We urge policy makers, members of the health professions, employer groups and others to come together around this 100 percent plan and look forward to working with them to make 100 percent coverage a reality," Lahn concluded.

"The 100 Percent Campaign: Health Insurance for Every Child," is a coordinated effort by Children Now, Children's Defense Fund and The Children's Partnership to ensure that all of California's children have quality health insurance.

A complete copy of the "Strategic Audit" is available from The Children's Partnership at 310/260-1220, or via e-mail at [e-mail]. The audit is also available online at www.100percentcampaign.org.